%0 Journal Article %@ 1438-8871 %I JMIR Publications %V 27 %N %P e54516 %T Mechanism Assessment of Physician Discourse Strategies and Patient Consultation Behaviors on Online Health Platforms: Mixed Methods Study %A Kong,Menglei %A Wang,Yu %A Li,Meixuan %A Yao,Zhong %+ School of Economics and Management, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing, 100083, China, 86 13811013409, 05723@buaa.edu.cn %K online health consultation %K physician discourse strategies %K online physician-patient trust %K shared decision-making %K patient consultation behavior %D 2025 %7 19.3.2025 %9 Original Paper %J J Med Internet Res %G English %X Background: Online health platforms are currently experiencing significant growth. Patients can conveniently seek medical consulting services on such platforms. Against the backdrop of the thriving development of digital health care, the patterns of physician-patient communication are undergoing profound changes. It is imperative to focus on physician discourse strategies during online physician-patient interactions, which will improve the efficiency of physician-patient communication and achieve better management of the physician-patient relationship. Objective: This study aims to explore the influencing mechanism between physician discourse strategies and patient consultation behavior on online health platforms. Additionally, we explore the crucial mediating role of online physician-patient trust and the moderating role of shared decision-making in the online physician-patient communication process. Methods: We used a mixed research approach to explore the influencing mechanism. Data on physician basic attributes and physician-patient communication text records were collected from the Chunyu Doctor website using a web spider. The study obtained a total of 8628 interaction texts from January 2022 to July 2023. Physician discourse strategies (capacity-oriented strategy, quality-oriented strategy, and goodwill-oriented strategy), online physician-patient trust, and shared decision-making were captured through text mining and a random forest model. First, we employed text mining to extract the speech acts, modal resources, and special linguistic resources of each record. Then, using a well-trained random forest model, we captured the specific discourse strategy of each interaction text based on the learned features and patterns. The study generated 863 groups of physician samples with 17 data fields. The hypotheses were tested using an “ordinary least squares” model, and a stability test was conducted by replacing the dependent variable. Results: The capacity-oriented strategy, goodwill-oriented strategy, and quality-oriented strategy had significant effects on patient consultation behavior (β=.151, P=.007; β=.154, P<.001; and β=.17, P<.001, respectively). It should be noted that the anticipated strong effect of the capacity-oriented strategy on patient consultation behavior was not observed. Instead, the effects of the quality-oriented strategy and goodwill-oriented strategy were more prominent. Physician notification adequacy from shared decision-making moderated the effect between the goodwill-oriented strategy and patient consultation behavior (β=.172; P<.001). Additionally, patient expression adequacy from shared decision-making moderated the effect between the capacity-oriented strategy and patient consultation behavior (β=.124; P<.001), and between the goodwill-oriented strategy and patient consultation behavior (β=.104; P=.003). Online physician-patient trust played a significant mediating role between physician discourse strategies and patient consultation behavior. Conclusions: The study findings suggest significant implications for stimulating patient consultation behavior on online health platforms by providing guidance on effective discourse strategies for physicians, thus constructing a trustworthy physician image, improving the physician-patient relationship, and increasing platform traffic. %M 40106798 %R 10.2196/54516 %U https://www.jmir.org/2025/1/e54516 %U https://doi.org/10.2196/54516 %U http://www.ncbi.nlm.nih.gov/pubmed/40106798 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e67999 %T Interprofessional Discussion for Knowledge Transfer in a Digital “Community of Practice” for Managing Pneumoconiosis: Mixed Methods Study %A Sood,Varinn Avi %A Rishel Brakey,Heidi %A Myers,Orrin %A Shore,Xin %A Sood,Akshay %K digital community of practice %K knowledge transfer %K pneumoconiosis %K telementoring %K rural health care %K rural professionals %K multidisciplinary management %K interprofessional discussion %K miner health %K health equity %K mixed methods %K digital health %K public health %K digital community %K self-efficacy %K quantitative analyses %K quantitative %K technology %K multidisciplinary care %K patient outcome %D 2025 %7 13.3.2025 %9 %J JMIR Form Res %G English %X Background: Pneumoconiosis prevalence is increasing in the United States, especially among coal miners. Contemporaneously with an increased need for specialized multidisciplinary care for miners, there is a shortage of experts to fulfill this need. Miners’ Wellness ECHO (Extension for Community Health Outcomes) is a digital community of practice based on interprofessional discussion for knowledge transfer. The program has been demonstrated to increase participants’ self-efficacy for clinical, medicolegal, and “soft” skills related to miners’ health. Objective: We aimed to examine characteristics associated with interprofessional discussions and suggest ways to strengthen knowledge transfer. Methods: This mixed methods study used an exploratory sequential design. We video-recorded and transcribed ECHO sessions over 14 months from July 2018 to September 2019 and analyzed content to examine participant discussions. We focused on participants’ statements of expertise followed by other participants’ acceptance or eschewal of these statements (utterances). We conducted quantitative analyses to examine the associations of active participation in discussion (primary outcome variable, defined as any utterance). We analyzed the association of the outcome on the following predictors: (1) participant group status, (2) study time frame, (3) participant ECHO experience status, (4) concordance of participant group identity between presenter and participant, (5) video usage, and (6) attendance frequency. We used the generalized estimating equations approach for longitudinal data, logit link function for binary outcomes, and LSMEANS to examine least squares means of fixed effects. Results: We studied 23 sessions with 158 unique participants and 539 total participants, averaging 23.4 (SD 5.6) participants per session. Clinical providers, the largest participant group, constituting 36.7% (n=58) of unique participants, were the most vocal group (mean 21.74, SD 2.11 average utterances per person-session). Benefits counselors were the least vocal group, with an average utterance rate of 0.57 (SD 0.29) per person-session and constituting 8.2% (n=13) of unique participants. Thus, various participant groups exhibited different utterance rates across sessions (P=.003). Experienced participants may have dominated active participation in discussion compared to those with less or intermediate experience, but this difference was not statistically significant (P=.11). When the didactic presenter and participant were from the same participant group, active participation by the silent group participants was greater than when both were from different groups. This association was not seen in vocal group participants (interaction P=.003). Compared to those participating by audio, those participating on video tended to have higher rates of active participation, but this difference was not statistically significant (P=.11). Conclusions: Our findings provide insight into the mechanics of interprofessional discussion in a digital community of practice managing pneumoconiosis. Our results underscore the capacity of the novel ECHO model to leverage technology and workforce diversity to facilitate interprofessional discussions on the multidisciplinary care of miners. Future research will evaluate whether this translates into improved patient outcomes. %R 10.2196/67999 %U https://formative.jmir.org/2025/1/e67999 %U https://doi.org/10.2196/67999 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e66744 %T Patients’ Experience With Evaluation by Both a Musculoskeletal Physician and Physical Therapist in the Same Digital Visit: Survey Study %A O'Connor,Mary I %A Chudy,Carolyn %A Peters,Kaitlyn C %A Ribaudo,Megan %A McCulloch,Carrie %A Aguilar,Jared %A Taylor,Trista %A Grant,Ryan A %K telemedicine %K musculoskeletal care %K patient satisfaction %K multidisciplinary care %K digital visit %D 2025 %7 3.3.2025 %9 %J JMIR Form Res %G English %X Background: Patients undergoing evaluation for musculoskeletal concerns are often seen by a physician and physical therapist in the in-person setting in a sequential manner. This process typically delays the onset of nonoperative care, inclusive of physical therapy, and creates the risk of inadequate clinical collaboration between physician and physical therapist. To address these issues, we designed a novel initial patient evaluation to a group visit in which both a specialty-trained musculoskeletal physician and physical therapist simultaneously evaluate a patient together in the digital encounter. Objective: The aim of the study is to gain insights from patients on their experience with this innovative digital simultaneous musculoskeletal medical doctor and physical therapist (MD+PT) visit format for the initial evaluation of musculoskeletal concerns. Methods: An electronic 7-question survey was sent to 750 patients who completed an MD+PT visit asking them to comment on prior musculoskeletal evaluations and their experience with the MD+PT format. Results: In total, 195 (26%) patients responded to the survey with the frequent body regions of diagnosis being lumbar spine (n=65), knee (n=32), shoulder (n=21), cervical spine (n=20), hip (n=14), and hand (n=11). Most patients had prior musculoskeletal experience with a physician or nurse practitioner (171/195, 87.7%) or physical therapist (148/195, 75.9%) with nearly all such encounters in the in-person setting (161/171,94.2% for physician or nurse practitioner and 144/148, 97.3% for physical therapy). Only 3.1% (6/193) of patients reported seeing both a physician and physical therapist during the same in-person visit. Patients rated the simultaneous MD+PT visit very favorably: this type of digital evaluation saved them time (179/192, 93.2%) and permitted them to promptly start their treatment plan (174/192, 90.6%). Overall, 87.5% (168/192) rated the MD+PT visit as enjoyable, and 92.2% (177/192) responded that it increased their confidence with understanding their medical condition and how to start treating it. Conclusions: Our early experience with the evaluation of patients with musculoskeletal conditions by both a specialty-trained musculoskeletal physician and physical therapist simultaneously in the same digital visit resulted in patients reporting a very positive experience with high satisfaction, engagement, and confidence in understanding their diagnosis and how to start treating it. %R 10.2196/66744 %U https://formative.jmir.org/2025/1/e66744 %U https://doi.org/10.2196/66744 %0 Journal Article %@ 2818-3045 %I JMIR Publications %V 2 %N %P e57361 %T A Local Training Program to Increase Awareness of Emerging Extended Reality Technologies Among Health Care Professionals: Development Study %A Galvin,Charlotte %A Watt,Jonathan %A Ghatnekar,Payal %A Peres,Nicholas %A Rees-Lee,Jacqueline %K health care XR %K extended reality in health care %K XR %K virtual reality in health care %K VR %K digital awareness training %K digital deep dive %K digital literacy %K emerging health care technology %K digital future %K extended reality %K virtual reality %D 2025 %7 27.2.2025 %9 %J JMIR XR Spatial Comput %G English %X Background: Demands on health care services can greatly outweigh capacity. Multifactorial causative factors present great challenges, forcing the National Health Service (NHS) to increase efficiency and adaptivity. Concurrently, digital advancements are excelling and long-term plans for NHS sustainability are focusing on the use of technological interventions to benefit patients. As a result, integration of extended reality (XR) technology has become an important focus of health care research. However, models of how the digital literacy of health care workforces can be developed and how frontline staff can be actively involved in the design and development of creative digital interventions are lacking. Such programs are essential to allow the development and upscaling of digital innovation within the NHS for the benefit of the patients. Such a program has been developed in the Digital Futures research lab at Torbay and South Devon NHS Foundation Trust, representing one of the first immersive digital technologies research spaces embedded within the NHS. A “Digital Deep Dive” training program has been developed, allowing local health care workers to recognize the possibilities of digital health care technologies and supporting them in the evolution of ideas for potential bespoke digital solutions appropriate to their own patient groups and care pathways. Objective: This paper aims to explain the development of this unique XR Deep Dive program and present the evaluation that informed future directions for its ongoing development. Methods: The Deep Dive sessions were designed according to relevant pedagogic principles, including experiential, active, and contextual learning theories. Voluntary pilot sessions were held for local clinical teams comprised of junior doctors, consultants, nurses, and allied health professionals. Self-selection sampling was used. Participants completed an anonymous postsession feedback form, which was used to conduct a service evaluation. Data were analyzed using descriptive statistics (quantitative) and thematic analysis (qualitative). Results: In total, 21 completed questionnaires were analyzed. Overall, the sessions were positively received: all participants reported increased awareness of the potential for digital health care innovation postsession and most found it useful and relevant to their clinical careers. Participants valued the sessions being grounded in a context relevant to local practice with opportunities to interact with the technology through the lens of use cases. Conclusions: We have developed a unique training initiative providing contextually relevant XR technology awareness training for health care professionals locally. Despite the growing pace of digital health care innovation, we recognized a knowledge gap in our local workforce regarding the potential of XR technologies within health care. We responded by developing a training program grounded in the concept of digital co-creation—working with staff and service users to develop bespoke solutions integrated within patient pathways. The results from this paper will help to inform future directions for developing digital awareness training in our trust and have implications for wider NHS digital literacy training. %R 10.2196/57361 %U https://xr.jmir.org/2025/1/e57361 %U https://doi.org/10.2196/57361 %0 Journal Article %@ 2818-3045 %I JMIR Publications %V 2 %N %P e60651 %T Understanding the Views of Health Care Professionals on the Usability and Utility of Virtual Reality Multidisciplinary Team Meetings: Usability and Utility Study %A Almashmoum,Maryam %A Payton,Antony %A Johnstone,Emily %A Cunningham,James %A Ainsworth,John %K knowledge sharing %K multidisciplinary team meetings %K artificial intelligence %K heuristic evaluation %K usability %K virtual reality %K VR %K simulation %K virtual environments %K digital environments %D 2025 %7 14.2.2025 %9 %J JMIR XR Spatial Comput %G English %X Background: Multidisciplinary team (MDT) meetings are one of the facilitators that enhance knowledge sharing among health care professionals. However, organizing a face-to-face MDT meeting to discuss patient treatment plans can be time-consuming. Virtual reality software is widely used in health care nowadays to save time and protect lives. Therefore, the use of virtual reality multidisciplinary team (VRMDT) meeting software may help enhance knowledge sharing between health care professionals and make meetings more efficient. Objective: The objectives of this study were to introduce VRMDT software for enhancing knowledge sharing and to evaluate the feasibility and usability of the VRMDT for use by professionals in health care institutions. Methods: We invited participants from The University of Manchester Faculty for Biology, Medicine, and Health who had a health care background. As this was the first stage of software development, individuals who did not usually attend MDT meetings were also invited via email to participate in this study. Participants evaluated VRMDT using a Meta Quest 3 headset, and software developed using the Unity platform. The software contained an onboarding tutorial that taught the participants how to select items, load and rotate 3D Digital Imaging and Communications in Medicine files, talk to a generative artificial intelligence–supported avatar, and make notes. After the evaluation (approximately 15 min), participants received an electronic survey using the Qualtrics survey tool (Qualtrics International Inc) to score the usability and feasibility of the software by responding to the 10-item system usability scale, and 12-point heuristic evaluation questions with Neilsen severity rating. Results: A total of 12 participants, including 4 health informatics, 3 with a nursing background, 2 medical doctors, 1 radiologist, and 2 biostatisticians, participated in the study. The most common age bracket of participants was 20‐30 years (6/12, 50%). Most of the respondents had no experience with virtual reality, either in educational or entertainment settings. The VRMDT received a mean usability score of 72.7 (range between 68 and 80.3), earning an overall “good” rating grade. The mean score of single items in the heuristic evaluation questionnaires was less than 1 out of 4 (the overall mean was 0.6), which indicates that only minor problems were encountered when using this software. Overall, the participant’s feedback was good with highlighted issues including a poor internet connection and the quality of the generative artificial intelligence response. Conclusions: VRMDT software (developed by SentiraXR) was developed with several functions aimed at helping health care professionals to discuss medical conditions efficiently. Participants found that the VRMDT is a powerful, and useful tool for enhancing knowledge sharing among professionals who are involved in MDT meetings due to its functionality and multiuser interactive environments. Additionally, there may be the possibility of using it to train junior professionals to interpret medical reports. %R 10.2196/60651 %U https://xr.jmir.org/2025/1/e60651 %U https://doi.org/10.2196/60651 %0 Journal Article %@ 2371-4379 %I JMIR Publications %V 10 %N %P e57526 %T Diabetes Medical Group Visits and Type 2 Diabetes Outcomes: Mediation Analysis of Diabetes Distress %A Reichert,Matthew %A De La Cruz,Barbara A %A Gardiner,Paula %A Mitchell,Suzanne %K diabetes %K diabetic %K diabetes mellitus %K DM %K type 1 diabetes %K type 2 diabetes %K diabetes mellitus type 2 %K diabetes outcomes %K diabetes medical group visit %K DMGVs %K psychosocial functioning %K psychosocial %K glycemic control %K glycemic %K shared medical appointments %K self-management %K mediation analysis %K social support %K minority women %K minority %D 2025 %7 6.2.2025 %9 %J JMIR Diabetes %G English %X Background: Group-based diabetes care, both technology-enabled and in-person, can improve diabetes outcomes in low-income minority women, but the mechanism remains unclear. Objective: We tested whether diabetes group medical visits (GMVs) reduced hemoglobin A1c (HbA1c) by mitigating diabetes distress (DD), an emotional response affecting nearly half of adults with type 2 diabetes in community settings. Methods: We conducted a mediation and moderation analysis of data from the Women in Control 2.0 comparative effectiveness study, which showed that both technology-enabled and in-person diabetes GMVs improve HbA1c. We tested whether DD mediated the relationship between diabetes GMV engagement and reductions in HbA1c. We also tested whether this relationship was moderated by depressive symptoms and social support. Participants were 309 low-income and minority women. Diabetes GMV engagement was measured using the Group Climate Questionnaire. The mediator, DD, was measured using the Diabetes Distress Screening Scale. The outcome was the 6-month change in HbA1c. Social support was measured using the Medical Outcomes Study Social Support Survey. Results: DD mediated the relationship between engagement and 6-month HbA1c. Specifically, group engagement affected HbA1c by reducing distress associated with the regimen of diabetes self-management (P=.04), and possibly the emotional burden of diabetes (P=.09). The relationship between engagement and 6-month HbA1c was moderated by depressive symptoms (P=.02), and possibly social support (P=.08). Conclusions: Engagement in diabetes GMVs improved HbA1c because it helped reduce diabetes-related distress, especially related to the regimen of diabetes management and possibly related to its emotional burden, and especially for women without depressive symptoms and possibly for women who lacked social support. Trial Registration: ClinicalTrials.gov NCT02726425; https://clinicaltrials.gov/study/NCT02726425 %R 10.2196/57526 %U https://diabetes.jmir.org/2025/1/e57526 %U https://doi.org/10.2196/57526 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e66121 %T The Use of Social Media on Enhancing Dental Care and Practice Among Dental Professionals: Cross-Sectional Survey Study %A Acosta,Joseph Macadaeg %A Detsomboonrat,Palinee %A Pisarnturakit,Pagaporn Pantuwadee %A Urwannachotima,Nipaporn %K social media %K oral health promotion %K oral health education %K dentists %K dental practice %K dental professionals %K dental practitioners %D 2025 %7 3.1.2025 %9 %J JMIR Form Res %G English %X 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 χ2 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. %R 10.2196/66121 %U https://formative.jmir.org/2025/1/e66121 %U https://doi.org/10.2196/66121 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e53344 %T Reflections From the Pandemic: Is Connectivism the Panacea for Clinicians? %A Benjamin,Jennifer %A Pillow,Tyson %A MacNeill,Heather %A Masters,Ken %A Agrawal,Anoop %A Mehta,Neil %+ Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Houston, TX, 77030, United States, 1 832 824 1000 ext 3436, jennifer.benjamin@bcm.edu %K learning theory %K learning framework %K connectivism %K panacea %K COVID-19 %K generative artificial intelligence %K GAI %K health care community %K clinician %K health care %K airborne disease %K learning %K information %K misinformation %K autonomy %K diversity %D 2024 %7 3.12.2024 %9 Viewpoint %J J Med Internet Res %G English %X The COVID-19 pandemic and the recent increased interest in generative artificial intelligence (GenAI) highlight the need for interprofessional communities’ collaboration to find solutions to complex problems. A personal narrative experience of one of the authors compels us to reflect on current approaches to learning and knowledge acquisition and use solutions to the challenges posed by GenAI through social learning contexts using connectivism. We recognize the need for constructivism and experiential learning for knowledge acquisition to establish foundational understanding. We explore how connectivist approaches can enhance traditional constructivist paradigms amid rapidly changing learning environments and online communities. Learning in connectivism includes interacting with experts from other disciplines and creating nodes of accurate and accessible information while distinguishing between misinformation and accurate facts. Autonomy, connectedness, diversity, and openness are foundational for learners to thrive in this learning environment. Learning in this environment is not just acquiring new knowledge as individuals but being connected to networks of knowledge, enabling health professionals to stay current and up-to-date. Existing online communities with accessible GenAI solutions allow for the application of connectivist principles for learning and knowledge acquisition. %M 39625749 %R 10.2196/53344 %U https://www.jmir.org/2024/1/e53344 %U https://doi.org/10.2196/53344 %U http://www.ncbi.nlm.nih.gov/pubmed/39625749 %0 Journal Article %@ 2292-9495 %I JMIR Publications %V 11 %N %P e52703 %T Exploring Patient, Proxy, and Clinician Perspectives on the Value and Impact of an Inpatient Portal: A Reflexive Thematic Analysis %A Schmidt,Simone %A Boulton,Adam %A Butler,Benita %A Fazio,Timothy %+ School of Computing and Information Systems, University of Melbourne, Melbourne Connect, 700 Swanston St, Melbourne, 3053, Australia, 61 481247167, simone.schmidt@unimelb.edu.au %K inpatient portal %K patient perspective %K clinician perspective %K information sharing %K clinician-patient relationship %K person-centered care %K reflexive thematic analysis %K qualitative research %K mobile phone %D 2024 %7 20.11.2024 %9 Original Paper %J JMIR Hum Factors %G English %X Background: Research exploring perspectives on inpatient portals reports that patients desire the information affordances of inpatient portals, and clinicians recognize their value for improving patient experience but also express caution regarding sharing aspects of the medical record. This study contributed to the existing literature on inpatient portals by considering the psychosocial dimension of clinician resistance to information sharing with inpatients and the power dynamic associated with clinician-patient information asymmetry. Along with the information affordances commonly discussed in this area, this study explored perspectives on the novel option to audio record consultations via an inpatient portal. Objective: This study aims to understand patient, proxy, and clinician perspectives on the value and impact of an inpatient portal within the Australian context. It explores clinician resistance and receptivity to sharing aspects of the medical record with patients and the power dynamic that characterizes the relationship between clinician and patient. It considers how an inpatient portal might assist in the transformation of this relationship such that this relationship could be characterized by greater information symmetry. Methods: Interviews were conducted with patients (n=20), proxies (n=4), and clinicians (n=21) recruited from 3 areas within the Royal Melbourne Hospital, where the portal would later be implemented. A largely inductive reflexive thematic analysis was conducted. Results: Patient and proxy participants reported that they wanted to understand what is happening in their care for peace of mind and that an inpatient portal could support this understanding. Clinician participants reflected on how they might transform their information-sharing practice to provide greater transparency in their relationship with patients. Participants considered the types of information that could be shared and how this information could be shared via an inpatient portal. Four key themes were generated: (1) affording the patient and proxy awareness, control, and reassurance through sharing accessible and meaningful information; (2) protecting the clinician and safeguarding quality health care in information sharing; (3) flexibly deploying the functions depending upon clinician, patient, proxy, and context; and (4) moving toward person-centered care: empowerment and equity via an inpatient portal. Conclusions: An inpatient portal provides an opportunity to reconceptualize the medical record and how this information might be shared with patients while they are admitted to the hospital, such that they have more understanding as to what is happening in their care, which ultimately supports their well-being. The transition to a more transparent information-sharing culture in the Australian hospital context will take time. An inpatient portal is a critical step in facilitating this transition and creating more informational symmetry in the clinician-patient relationship. %M 39566905 %R 10.2196/52703 %U https://humanfactors.jmir.org/2024/1/e52703 %U https://doi.org/10.2196/52703 %U http://www.ncbi.nlm.nih.gov/pubmed/39566905 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e52924 %T A SIMBA CoMICs Initiative to Cocreating and Disseminating Evidence-Based, Peer-Reviewed Short Videos on Social Media: Mixed Methods Prospective Study %A Elhariry,Maiar %A Malhotra,Kashish %A Goyal,Kashish %A Bardus,Marco %A Team,SIMBA and CoMICs %A Kempegowda,Punith %+ Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom, 44 7721930777, p.kempegowda@bham.ac.uk %K influencers %K social media %K public engagement %K apps %K healthcare %K medical students %K online medical information %K simulation %K peer-reviewed information %D 2024 %7 30.10.2024 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 39475500 %R 10.2196/52924 %U https://mededu.jmir.org/2024/1/e52924 %U https://doi.org/10.2196/52924 %U http://www.ncbi.nlm.nih.gov/pubmed/39475500 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e50057 %T Impact of Concurrent Media Exposure on Professional Identity: Cross-Sectional Study of 1087 Medical Students During Long COVID %A Wu,Manli %A Yan,Jun %A Qiao,Chongming %A Yan,Chu %+ School of Journalism and Information Communication, Huazhong University of Science and Technology, School of Journalism and Information Communication, HUST, Number 1037, Luoyu Road, Wuhan, 430074, China, 86 18971629738, junyan@hust.edu.cn %K COVID-19 %K media exposure %K social support %K professional identity %K medical students %K Stimulus-Organism-Response framework %D 2024 %7 17.10.2024 %9 Original Paper %J J Med Internet Res %G English %X 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 (β=.163; P<.001) and emotional support (β=.084; P=.007). Similarly, social media exposure showed positive associations with informational support (β=.122; P<.001) and emotional support (β=.235; P<.001). Thereafter, informational support (β=.228; P<.001) and emotional support (β=.344; P<.001) were positively associated with students’ sense of belonging. Meanwhile, both informational support (β=.245; P<.001) and emotional support (β=.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. %M 39418080 %R 10.2196/50057 %U https://www.jmir.org/2024/1/e50057 %U https://doi.org/10.2196/50057 %U http://www.ncbi.nlm.nih.gov/pubmed/39418080 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e53705 %T Exploring Physicians’ Perceptions of Digital Health’s Impact on the Patient-Physician Relationship in the Primary Health Care Setting: Qualitative Descriptive Study %A Sze,Kai Ping %A Fong,Qi Wei %A De Roza,Jacqueline Giovanna %A Lee,Eng Sing %A Tan,Shu Yun %+ National Healthcare Group Polyclinics, 3 Fusionopolis Link, #03-08, Singapore, 138543, Singapore, 65 63553000, kai_ping_sze@nhgp.com.sg %K patient-physician relationship %K patient communication %K trust %K primary care medicine %K digital health %K primary care %K longitudinal care %K policy %K implementation %D 2024 %7 15.10.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain. Objective: This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective. Methods: This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes. Results: We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised “social and personal,” “technical and material,” and “organization and policy” factors. Conclusions: The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship. %M 39405515 %R 10.2196/53705 %U https://www.jmir.org/2024/1/e53705 %U https://doi.org/10.2196/53705 %U http://www.ncbi.nlm.nih.gov/pubmed/39405515 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e45291 %T Impact of a New Gynecologic Oncology Hashtag During Virtual-Only ASCO Annual Meetings: An X (Twitter) Social Network Analysis %A Bhandoria,Geetu %A Bilir,Esra %A Uwins,Christina %A Vidal-Alaball,Josep %A Fuster-Casanovas,Aïna %A Ahmed,Wasim %K social media %K academic tweeting %K hashtag %K gynecologic oncology %K Twitter %K ASCO %K gynecology %K oncology %K virtual %K engagement %K software application %K users %K cancer %K social network %K health promotion %D 2024 %7 14.8.2024 %9 %J JMIR Med Educ %G English %X Background: Official conference hashtags are commonly used to promote tweeting and social media engagement. The reach and impact of introducing a new hashtag during an oncology conference have yet to be studied. The American Society of Clinical Oncology (ASCO) conducts an annual global meeting, which was entirely virtual due to the COVID-19 pandemic in 2020 and 2021. Objective: This study aimed to assess the reach and impact (in the form of vertices and edges generated) and X (formerly Twitter) activity of the new hashtags #goASCO20 and #goASCO21 in the ASCO 2020 and 2021 virtual conferences. Methods: New hashtags (#goASCO20 and #goASCO21) were created for the ASCO virtual conferences in 2020 and 2021 to help focus gynecologic oncology discussion at the ASCO meetings. Data were retrieved using these hashtags (#goASCO20 for 2020 and #goASCO21 for 2021). A social network analysis was performed using the NodeXL software application. Results: The hashtags #goASCO20 and #goASCO21 had similar impacts on the social network. Analysis of the reach and impact of the individual hashtags found #goASCO20 to have 150 vertices and 2519 total edges and #goASCO20 to have 174 vertices and 2062 total edges. Mentions and tweets between 2020 and 2021 were also similar. The circles representing different users were spatially arranged in a more balanced way in 2021. Tweets using the #goASCO21 hashtag received significantly more responses than tweets using #goASCO20 (75 times in 2020 vs 360 times in 2021; z value=16.63 and P<.001). This indicates increased engagement in the subsequent year. Conclusions: Introducing a gynecologic oncology specialty–specific hashtag (#goASCO20 and #goASCO21) that is related but different from the official conference hashtag (#ASCO20 and #ASCO21) helped facilitate discussion on topics of interest to gynecologic oncologists during a virtual pan-oncology meeting. This impact was visible in the social network analysis. %R 10.2196/45291 %U https://mededu.jmir.org/2024/1/e45291 %U https://doi.org/10.2196/45291 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e46073 %T Online Medical Consultation Service–Oriented Recommendations: Systematic Review %A Jiang,Hongxun %A Mi,Ziyue %A Xu,Wei %+ School of Information, Renmin University of China, 59 Zhongguancun Street, Haidian District, Beijing, 100872, China, 86 01082500904, weixu@ruc.edu.cn %K online health community %K online medical consultation %K personalized recommendations %K 2-sided matching %K load balancing %D 2024 %7 30.7.2024 %9 Review %J J Med Internet Res %G English %X Background: Online health communities have given rise to a new e-service known as online medical consultations (OMCs), enabling remote interactions between physicians and patients. To address challenges, such as patient information overload and uneven distribution of physician visits, online health communities should develop OMC-oriented recommenders. Objective: We aimed to comprehensively investigate what paradigms lead to the success of OMC-oriented recommendations. Methods: A literature search was conducted through e-databases, including PubMed, ACM Digital Library, Springer, and ScienceDirect, from January 2011 to December 2023. This review included all papers directly and indirectly related to the topic of health care–related recommendations for online services. Results: The search identified 611 articles, of which 26 (4.3%) met the inclusion criteria. Despite the growing academic interest in OMC recommendations, there remains a lack of consensus among researchers on the definition of e-service–oriented recommenders. The discussion highlighted 3 key factors influencing recommender success: features, algorithms, and metrics. It advocated for moving beyond traditional e-commerce–oriented recommenders to establish an innovative theoretical framework for e-service–oriented recommenders and addresses critical technical issues regarding 2-sided personalized recommendations. Conclusions: This review underscores the essence of e-services, particularly in knowledge- and labor-intensive domains such as OMCs, where patients seek interpretable recommendations due to their lack of domain knowledge and physicians must balance their energy levels to avoid overworking. Our study’s findings shed light on the importance of customizing e-service–oriented personalized recommendations to meet the distinct expectations of 2-sided users considering their cognitive abilities, decision-making perspectives, and preferences. To achieve this, a paradigm shift is essential to develop unique attributes and explore distinct content tailored for both parties involved. %M 38777810 %R 10.2196/46073 %U https://www.jmir.org/2024/1/e46073 %U https://doi.org/10.2196/46073 %U http://www.ncbi.nlm.nih.gov/pubmed/38777810 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e51506 %T 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 %A Storman,Dawid %A Jemioło,Paweł %A Sawiec,Zuzanna %A Swierz,Mateusz Jan %A Antonowicz,Ewa %A Bala,Malgorzata M %A Prokop-Dorner,Anna %+ Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kopernika 7, Kraków, 31-034, Poland, 48 124223720, dawid.storman@uj.edu.pl %K anxiety disorders %K depression %K peer-to-peer web-based interactions %K needs %K psychiatric hospitalization %D 2024 %7 12.7.2024 %9 Original Paper %J J Med Internet Res %G English %X 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 χ2 test, and φ 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. %R 10.2196/51506 %U https://www.jmir.org/2024/1/e51506 %U https://doi.org/10.2196/51506 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e55680 %T Using Twitter (X) to Mobilize Knowledge for First Contact Physiotherapists: Qualitative Study %A Campbell,Laura %A Quicke,Jonathan %A Stevenson,Kay %A Paskins,Zoe %A Dziedzic,Krysia %A Swaithes,Laura %+ Impact Accelerator Unit, School of Medicine, Keele University, David Weatherall Building, Staffordshire, ST5 5BG, United Kingdom, 44 01782734727, l.campbell@keele.ac.uk %K Twitter %K X %K social media %K first contact physiotherapy %K musculoskeletal %K knowledge mobilisation %K primary care %K mindlines %K qualitative %K physiotherapy %K implementation %D 2024 %7 8.7.2024 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 38742615 %R 10.2196/55680 %U https://www.jmir.org/2024/1/e55680 %U https://doi.org/10.2196/55680 %U http://www.ncbi.nlm.nih.gov/pubmed/38742615 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e51698 %T A Typology of Social Media Use by Human Service Nonprofits: Mixed Methods Study %A Xue,Jia %A Shier,Micheal L %A Chen,Junxiang %A Wang,Yirun %A Zheng,Chengda %A Chen,Chen %+ Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada, 1 4169465429, jia.xue@utoronto.ca %K human service nonprofits %K sexual assault support centers %K Canada %K typology %K theory %K Twitter %K machine learning %K social media %K tweet %K tweets %K nonprofit %K nonprofits %K crisis %K sexual assault %K sexual violence %K sexual abuse %K support center %K support centers %K communication %K communications %K organization %K organizations %K organizational %K sentiment analysis %K business %K marketing %D 2024 %7 8.5.2024 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 38718390 %R 10.2196/51698 %U https://www.jmir.org/2024/1/e51698 %U https://doi.org/10.2196/51698 %U http://www.ncbi.nlm.nih.gov/pubmed/38718390 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e52646 %T Effect of Prosocial Behaviors on e-Consultations in a Web-Based Health Care Community: Panel Data Analysis %A Liu,Xiaoxiao %A Guo,Huijing %A Wang,Le %A Hu,Mingye %A Wei,Yichan %A Liu,Fei %A Wang,Xifu %+ Healthcare Simulation Center, Guangzhou First People’s Hospital, 1 Pan Fu Road, Yuexiu District, Guangzhou, 510180, China, 86 13560055951, wangxifu.simulation@gmail.com %K prosocial behaviors %K proactive behaviors %K reactive behaviors %K reputations %K e-consultation volume %K live streaming %D 2024 %7 25.4.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: Patients using web-based health care communities for e-consultation services have the option to choose their service providers from an extensive digital market. To stand out in this crowded field, doctors in web-based health care communities often engage in prosocial behaviors, such as proactive and reactive actions, to attract more users. However, the effect of these behaviors on the volume of e-consultations remains unclear and warrants further exploration. Objective: This study investigates the impact of various prosocial behaviors on doctors’ e-consultation volume in web-based health care communities and the moderating effects of doctors’ digital and offline reputations. Methods: A panel data set containing information on 2880 doctors over a 22-month period was obtained from one of the largest web-based health care communities in China. Data analysis was conducted using a 2-way fixed effects model with robust clustered SEs. A series of robustness checks were also performed, including alternative measurements of independent variables and estimation methods. Results: Results indicated that both types of doctors’ prosocial behaviors, namely, proactive and reactive actions, positively impacted their e-consultation volume. In terms of the moderating effects of external reputation, doctors’ offline professional titles were found to negatively moderate the relationship between their proactive behaviors and their e-consultation volume. However, these titles did not significantly affect the relationship between doctors’ reactive behaviors and their e-consultation volume (P=.45). Additionally, doctors’ digital recommendations from patients negatively moderated both the relationship between doctors’ proactive behaviors and e-consultation volume and the relationship between doctors’ reactive behaviors and e-consultation volume. Conclusions: Drawing upon functional motives theory and social exchange theory, this study categorizes doctors’ prosocial behaviors into proactive and reactive actions. It provides empirical evidence that prosocial behaviors can lead to an increase in e-consultation volume. This study also illuminates the moderating roles doctors’ digital and offline reputations play in the relationships between prosocial behaviors and e-consultation volume. %M 38663006 %R 10.2196/52646 %U https://www.jmir.org/2024/1/e52646 %U https://doi.org/10.2196/52646 %U http://www.ncbi.nlm.nih.gov/pubmed/38663006 %0 Journal Article %@ 2562-0959 %I JMIR Publications %V 7 %N %P e51267 %T Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health %A Karadag,Ayse Serap %A Kandi,Basak %A Sanlı,Berna %A Ulusal,Hande %A Basusta,Hasan %A Sener,Seray %A Calıka,Sinem %+ Department of Dermatology, Medical School of Istanbul Arel University, Türkoba, Erguvan Sk No: 26, Istanbul, 34537, Turkey, 90 533 655 22 60, karadagaserap@gmail.com %K social media %K dermatology %K internet %K health promotion %K patient education %K Instagram %K YouTube %K online social networking %K social networking %K Turkey %K patient health %K skin %K skin disease %K skincare %K cosmetics %K digital communication %K misinformation %D 2024 %7 28.3.2024 %9 Viewpoint %J JMIR Dermatol %G English %X Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on “How social media works” at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists’ experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered. %M 38546714 %R 10.2196/51267 %U https://derma.jmir.org/2024/1/e51267 %U https://doi.org/10.2196/51267 %U http://www.ncbi.nlm.nih.gov/pubmed/38546714 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e50552 %T Bridging and Bonding Social Capital by Analyzing the Demographics, User Activities, and Social Network Dynamics of Sexual Assault Centers on Twitter: Mixed Methods Study %A Xue,Jia %A Zhang,Qiaoru %A Zhang,Yun %A Shi,Hong %A Zheng,Chengda %A Fan,Jingchuan %A Zhang,Linxiao %A Chen,Chen %A Li,Luye %A Shier,Micheal L %+ Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada, 1 416 946 5429, jia.xue@utoronto.ca %K social media %K Twitter %K sexual assault %K nonprofits %K Canada %K violence %K geolocation %K communication %D 2024 %7 27.3.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: Social media platforms have gained popularity as communication tools for organizations to engage with clients and the public, disseminate information, and raise awareness about social issues. From a social capital perspective, relationship building is seen as an investment, involving a complex interplay of tangible and intangible resources. Social media–based social capital signifies the diverse social networks that organizations can foster through their engagement on social media platforms. Literature underscores the great significance of further investigation into the scope and nature of social media use, particularly within sectors dedicated to service delivery, such as sexual assault organizations. Objective: This study aims to fill a research gap by investigating the use of Twitter by sexual assault support agencies in Canada. It seeks to understand the demographics, user activities, and social network structure within these organizations on Twitter, focusing on building social capital. The research questions explore the demographic profile, geographic distribution, and Twitter activity of these organizations as well as the social network dynamics of bridging and bonding social capital. Methods: This study used purposive sampling to investigate sexual assault centers in Canada with active Twitter accounts, resulting in the identification of 124 centers. The Twitter handles were collected, yielding 113 unique handles, and their corresponding Twitter IDs were obtained and validated. A total of 294,350 tweets were collected from these centers, covering >93.54% of their Twitter activity. Preprocessing was conducted to prepare the data, and descriptive analysis was used to determine the center demographics and age. Furthermore, geolocation mapping was performed to visualize the center locations. Social network analysis was used to explore the intricate relationships within the network of sexual assault center Twitter accounts, using various metrics to assess the network structure and connectivity dynamics. Results: The results highlight the substantial presence of sexual assault organizations on Twitter, particularly in provinces such as Ontario, British Columbia, and Quebec, underscoring the importance of tailored engagement strategies considering regional disparities. The analysis of Twitter account creation years shows a peak in 2012, followed by a decline in new account creations in subsequent years. The monthly tweet activity shows November as the most active month, whereas July had the lowest activity. The study also reveals variations in Twitter activity, account creation patterns, and social network dynamics, identifying influential social queens and marginalized entities within the network. Conclusions: This study presents a comprehensive landscape of the demographics and activities of sexual assault centers in Canada on Twitter. This study suggests that future research should explore the long-term consequences of social media use and examine stakeholder perceptions, providing valuable insights to improve communication practices within the nonprofit human services sector and further the missions of these organizations. %M 38536222 %R 10.2196/50552 %U https://www.jmir.org/2024/1/e50552 %U https://doi.org/10.2196/50552 %U http://www.ncbi.nlm.nih.gov/pubmed/38536222 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52414 %T Transfer of Knowledge on Pneumoconiosis Care Among Rural-Based Members of a Digital Community of Practice: Cross-Sectional Study %A Soller,Brian %A Myers,Orrin %A Sood,Akshay %+ Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico MSC 10 5550, Albuquerque, NM, 871310001, United States, 1 5052724751, asood@salud.unm.edu %K community of practice %K knowledge transfer %K pneumoconiosis %K telementoring %K rural health care %K transfer %K information %K rural %K virtual community %K lung diseases %K lung disease %K rural professionals %K rural professional %K multidisciplinary management %K multidisciplinary %K miners %K miner %K health equity %D 2024 %7 24.1.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Given the re-emergence of coal workers’ pneumoconiosis in Appalachia and Mountain West United States, there is a tremendous need to train rural professionals in its multidisciplinary management. Since 2016, the Miners’ Wellness TeleECHO (Extension for Community Health Outcomes) Program held by the University of New Mexico, Albuquerque, and Miners’ Colfax Medical Center, Raton, New Mexico, provides structured longitudinal multidisciplinary telementoring to diverse professionals taking care of miners by creating a digital community of practice. Program sessions emphasize active learning through discussion, rather than didactic training. Professional stakeholder groups include respiratory therapists, home health professionals, benefits counselors, lawyers or attorneys, clinicians, and others. Rural-urban differences in knowledge transfer in such a community of practice, however, remain unknown. Objective: We aim to evaluate the role of the rurality of the patient or client base in the transfer of knowledge to professionals caring for miners using the digital community of practice approach. Methods: This is a cross-sectional study of 70 professionals participating in the Miners’ Wellness TeleECHO Program between 2018 and 2019. Drawing insights from social network analysis, we examined the association between the rurality of participants’ patient or client base and their self-reported receipt of knowledge. Our focal independent variable was the respondent’s self-reported percentage of patients or clients who reside in rural areas. We measured knowledge transfer sources by asking participants if they received knowledge regarding the care of miners during and outside of TeleECHO sessions from each of the other participants. Our dependent variables included the number of knowledge sources, number of cross-stakeholder knowledge sources, number of same stakeholder knowledge sources, and range and heterogeneity of knowledge sources. Results: Respondents, on average, identified 4.46 (SD 3.16) unique knowledge sources within the community, with a greater number of cross-stakeholder knowledge sources (2.80) than same stakeholder knowledge sources (1.72). The mean knowledge source range was 2.50 (SD 1.29), indicating that, on average, respondents received knowledge sources from roughly half of the 5 stakeholder groups. Finally, the mean heterogeneity of knowledge sources, which can range between 0 and 0.80, was near the midpoint of the scale at 0.44 (SD 0.30). Multivariable analyses revealed that as the rurality of patient or client bases increased, participants reported more knowledge sources overall, more knowledge sources from outside of their stakeholder groups, a higher knowledge source range, and greater heterogeneity of knowledge sources (P<.05 for all comparisons). Conclusions: Our findings suggest that participants who serve rural areas especially benefit from knowledge transfer within the TeleECHO community of practice. Additionally, the knowledge they receive comes from diverse information sources, emphasizing its multidisciplinary nature. Our results underscore the capacity of the TeleECHO model to leverage technology to promote rural health equity for miners. %M 38265861 %R 10.2196/52414 %U https://formative.jmir.org/2024/1/e52414 %U https://doi.org/10.2196/52414 %U http://www.ncbi.nlm.nih.gov/pubmed/38265861 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 12 %N %P e50208 %T Experiences and Priorities in Youth and Family Mental Health: Protocol for an Arts-Based Priority-Setting Focus Group Study %A Archibald,Mandy %A Makinde,Sharifat %A Tongol,Nicole %A Levasseur-Puhach,Sydney %A Roos,Leslie %+ University of Manitoba, Helen Glass Centre for Nursing, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada, 1 2044746660, mandy.archibald@umanitoba.ca %K arts-based methods %K priority setting %K mental health %K eHealth %K arts-based %K art-based %K preference %K preferences %K perspective %K perspectives %K opinion %K opinions %K youth %K adolescent %K adolescents %K immigrant %K immigrants %K native %K natives %K aboriginal %K aboriginals %K Indigenous %K digital health %K telehealth %K telemedicine %D 2023 %7 7.11.2023 %9 Protocol %J JMIR Res Protoc %G English %X Background: During the COVID-19 pandemic, eHealth services enabled providers to reach families despite widespread social distancing restrictions. However, their rapid adoption often occurred without community partners’ involvement and without an understanding of how they prioritize aspects of their mental health and associated service provision, both of which promote family and community-centered health care delivery. Establishing priorities in health care is essential for developing meaningful and reliable health services. As such, there is an urgent need to understand how eHealth service users, especially families who may have historically faced oppression and systemic barriers to service access, can best benefit from them. Arts-based approaches can elicit an understanding of priorities by providing an engaging and expressive means of moving beyond readily expressible discursive language and stimulating meaningful dialogue reflective of participants’ lived experiences. Objective: The purpose of this research is to determine the priorities and preferences of youth; parents or caregivers; newcomers and immigrants; and Indigenous community members regarding the use of eHealth in supporting their mental health using an innovative arts-based priority-setting method. Methods: This study uses a mixed-methods approach combining qualitative, quantitative, and arts-based research. It follows a survey used to identify key knowledge partners who are interested in improving eHealth services for mental health support in Manitoba, Canada. Knowledge partners interested in group-based priority setting will be contacted to participate. We will facilitate approximately two focus groups across each subgroup of youth, parents or caregivers, newcomers or immigrants, and Indigenous community members using an integrative, quantitatively anchored arts-based method termed the “Circle of Importance” to understand participants’ mental health priorities and how eHealth or technology may support their mental well-being. The Circle of Importance involves placing small objects, whose meaning is determined by participants, on a visual board with concentric circles that correspond to a 5-point Likert scale of importance. Following each focus group, we will evaluate participants’ and focus group facilitators’ experiences of the Circle of Importance using a survey and follow-up structured in-person interviews to garner how we can improve the arts-based approach used in the focus groups. Results: The PRIME (Partnering for Research Innovation in Mental Health through eHealth Excellence) theme received institutional ethics approval on August 23, 2023. Data collection is projected for August 2023, with follow-up focus groups occurring in early 2024 as required. Data analysis will occur immediately following data collection. Conclusions: Findings will directly inform a multiyear applied research agenda for PRIME aimed at improving mental health services through engaging key knowledge partners. The results may inform how arts-based methods in a priority setting can reflect aspects of experience beyond the capacities of qualitative or quantitative methods alone, and whether this approach aligns well with a positive experience of research participation. International Registered Report Identifier (IRRID): PRR1-10.2196/50208 %M 37934557 %R 10.2196/50208 %U https://www.researchprotocols.org/2023/1/e50208 %U https://doi.org/10.2196/50208 %U http://www.ncbi.nlm.nih.gov/pubmed/37934557 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e52509 %T System-Wide Change Is Essential to Value the Contributions of Women in Medicine and Science %A Jain,Shikha %A Allan,Jessica M %A Bhayani,Rakhee K %+ Department of Medicine, University of Illinois at Chicago, 1740 W Taylor St, Chicago, IL, 60612, United States, 1 773 960 2567, sjain03@gmail.com %K women %K women physicians %K women scientists %K gender equity %K health care %K diversity %K leadership %K intersectionality %K minority tax %K gratitude tax %K glass ceiling %K glass cliff %K academia %K academic medicine %K hierarchy %K change %D 2023 %7 22.9.2023 %9 Editorial %J J Med Internet Res %G English %X The persistent and pervasive gender gap in health care is a fact backed by data, science, and evidence. This editorial aims to describe some of the challenges that continue to persist. Many of the strategies outlined can be implemented both locally and nationally to effect meaningful change and work toward closing the existing gender gap in health care. %M 37738082 %R 10.2196/52509 %U https://www.jmir.org/2023/1/e52509 %U https://doi.org/10.2196/52509 %U http://www.ncbi.nlm.nih.gov/pubmed/37738082 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e47933 %T Five Strategies Leaders in Academic Medicine Can Implement Now to Enhance Gender Equity %A Allan,Jessica M %A Brooks,Amber K %A Crusto,Cindy %A Feld,Lauren D %A Oxentenko,Amy S %A Spector,Nancy D %A Verduzco-Gutierrez,Monica %A Silver,Julie K %+ Department of Physical Medicine and Rehabilitation, Harvard Medical School, 300 First Avenue, Boston, MA, 02129, United States, 1 617 952 5000, julie_silver@hms.harvard.edu %K gender equity %K diversity %K leadership %K academic medicine %K gender %K medicine %K women in medicine %K strategies %K leadership %K equity %D 2023 %7 13.6.2023 %9 Viewpoint %J J Med Internet Res %G English %X Abundant disparities for women in medicine contribute to many women physicians considering leaving medicine. There is a strong financial and ethical case for leaders in academic medicine to focus on strategies to improve retention. This article focuses on five immediate actions that leaders can take to enhance gender equity and improve career satisfaction for all members of the workplace. %M 37310782 %R 10.2196/47933 %U https://www.jmir.org/2023/1/e47933 %U https://doi.org/10.2196/47933 %U http://www.ncbi.nlm.nih.gov/pubmed/37310782 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e47641 %T Four Lessons Learned From Career Pivots in Academic Medicine %A Allen,Jay-Sheree %A Oxentenko,Amy %+ Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, United States, 1 507 266 4347, allen.jay-sheree@mayo.edu %K women %K academic medicine %K career %K pivot %K transition %K women in medicine %D 2023 %7 13.6.2023 %9 Viewpoint %J J Med Internet Res %G English %X Women in the fields of medicine and science often consider career pivots to transition out or transition up; in this review, we offer 4 lessons learned to make those pivots maximally successful. These lessons emphasize the need to honor the feeling that it is time to pivot, especially if you develop a strong sense of restlessness indicating you are in a space that no longer serves you; they also emphasize the importance of seeking the guidance of a mentor, sponsor, or coach. Although flexibility is a substantial part of the transition, it is important to have a road map in the form of a career development plan, and it is of utmost importance to complete the transition professionally. %M 37310784 %R 10.2196/47641 %U https://www.jmir.org/2023/1/e47641 %U https://doi.org/10.2196/47641 %U http://www.ncbi.nlm.nih.gov/pubmed/37310784 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e42214 %T Web-Based, Interactive, Interest-Based Negotiation Training for Managing Conflict in Isolated Environments: Opportunistic Study With an e-Survey %A Fleischer,Jennifer %A Ayton,Jeff %A Riley,Maree %A Binsted,Kim %A Cowan,Devin R %A Fellows,Abigail M %A Weiss,Jeff A %A Buckey,Jay C %+ Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, United States, 1 603 650 6012, jennfleischer@gmail.com %K conflict management %K bargaining %K confined environments %K COVID-19 %K pandemic %K development %K environment %K skill %K training %K users %K essential %K Australia %K management %D 2023 %7 9.6.2023 %9 Original Paper %J JMIR Form Res %G English %X Background: Effective negotiation in relationships is critical for successful long-duration space missions; inadequate conflict resolution has shown serious consequences. Less desirable forms of negotiation, including positional bargaining (eg, negotiating prices), can exacerbate conflicts. Traditional positional bargaining may work for simple, low-stakes transactions but does not prioritize ongoing relationships. High-stakes situations warrant interest-based negotiation, where parties with competing interests or goals collaborate in a mutually beneficial agreement. This is learnable but must be practiced. Refresher training during conflicts is important to prevent out-of-practice crew members from using less effective negotiation techniques. Training should be self-directed and not involve others because, on a space mission, the only other people available may be part of the conflict. Objective: We aimed to develop and test an interactive module teaching principles and skills of interest-based negotiation in a way that users find acceptable, valuable for learning, and enjoyable. Methods: Using a web-based, interactive-media approach, we scripted, filmed, and programmed an interest-based negotiation interactive training module. In the module, the program mentor introduces users to “The Circle of Value” approach to negotiation and highlights its key concepts through interactive scenarios requiring users to make selections at specific decision points. Each selection prompts feedback designed to reinforce a teaching point or highlight a particular negotiation technique. To evaluate the module, we sought populations experiencing isolation and confinement (an opportunistic design). This included 9 participants in isolated, confined environments in the Australian Antarctic Program and the Hawai'i Space Exploration Analog and Simulation Mars simulation, as well as a subset of people who self-identified as being isolated and confined during the COVID-19 pandemic. Feedback was collected from participants (n=54) through free-response answers and questionnaires with numerical scaling (0=strongly disagree to 4=strongly agree) at the end of the module. Results: In total, 51 of 54 (94%) participants found the activity valuable for learning about conflict management (identified by those who selected either “somewhat agree” or “strongly agree”), including 100% of participants in the isolated and confined environment subset (mode=3). In total, 79% (128/162) of participant responses indicated that the module was realistic (mode=3), including 85% (23/27) of responses from participants in isolated and confined environments (mode=3). Most participants felt that this would be particularly valuable for new team members in an isolated, confined environment (46/54, 85% of all participants, mode 4; 7/9, 78% of the isolated and confined environment subset, mode 3) as well as veterans. Conclusions: This module offers a self-directed, consistent approach to interest-based negotiation training, which is well received by users. Although the data are limited due to the opportunistic study design, the module could be useful for individuals in isolated and confined environments and for anyone involved in high-stakes negotiations where sustaining relationships is essential. %M 37075233 %R 10.2196/42214 %U https://formative.jmir.org/2023/1/e42214 %U https://doi.org/10.2196/42214 %U http://www.ncbi.nlm.nih.gov/pubmed/37075233 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e48965 %T Description of the Novel Networking, Open Discussion, Engagement, and Self-Promotion (NODES) Framework for the Advancement of Women Physicians on Social Media %A Pendergrast,Tricia %+ Northwestern University Feinberg School of Medicine, 303 East Chicago Ave, Suite 1-003, Chicago, IL, 60611, United States, 1 312 503 8194, triciarpendergrast@gmail.com %K social media %K gender equity %K women in medicine %K woman physician %K NODES framework %K self-promotion %K networking %K open discussion %D 2023 %7 8.6.2023 %9 Viewpoint %J J Med Internet Res %G English %X The Networking, Open Discussion, Engagement, and Self-Promotion (NODES) framework is a strategy that women in medicine can deploy at conferences to broaden their professional networks and engage with colleagues. The NODES framework was designed and implemented for use at the Women in Medicine Summit, an annual conference that unites women to combat gender inequality in medicine. Intentional use of social media at conferences using the NODES framework by women in medicine can increase the visibility of research projects and may lead to speaking engagements and awards. %M 37289490 %R 10.2196/48965 %U https://www.jmir.org/2023/1/e48965 %U https://doi.org/10.2196/48965 %U http://www.ncbi.nlm.nih.gov/pubmed/37289490 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e47800 %T Flattening Hierarchical Structures to Empower Women Trainee Leaders on Social Media Teams %A Kays,Marah N %A Rupert,Deborah D %A Negris,Olivia %A Thompson,Beatrix %A Clayman,Marla L %A Mordell,Lisa %A Pendergrast,Tricia %A Bloomgarden,Eve %A Bhayani,Rakhee K %A Jain,Shikha %+ Division of Hematology and Oncology, University of Illinois at Chicago, 1740 W Taylor St, Chicago, IL, 60612, United States, 1 312 355 1625, sjain03@gmail.com %K social media %K medical education %K gender equity %K women %K empowerment %K pyramidal hierarchy %K residency %K medical training %K health care %K women empowerment %D 2023 %7 5.6.2023 %9 Editorial %J J Med Internet Res %G English %X We share our experience empowering women trainees and leadership through a flattened hierarchical social media team structure with supporting evidence from measurable outcomes. %M 37276011 %R 10.2196/47800 %U https://www.jmir.org/2023/1/e47800 %U https://doi.org/10.2196/47800 %U http://www.ncbi.nlm.nih.gov/pubmed/37276011 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e47783 %T Investing in Women Trainees: Building a Women in Medicine Group at an Academic Institution %A Zhong,Lydia %A Lee,Koeun %A Baggstrom,Maria Q %A Bhayani,Rakhee K %+ Division of General Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St Louis, MO, United States, 1 9097675384, lmzhong@wustl.edu %K gender equity %K graduate medical education %K women in medicine %K trainee wellness %K women %K gender gap %K inequity %K medical training %K medicine %D 2023 %7 31.5.2023 %9 Editorial %J J Med Internet Res %G English %X Given the importance of proactively supporting women trainees in medicine to address gender inequities, we draw on the experience of a well-established professional development initiative to provide a framework for other institutions seeking to create similar trainee-focused programs. %M 37256684 %R 10.2196/47783 %U https://www.jmir.org/2023/1/e47783 %U https://doi.org/10.2196/47783 %U http://www.ncbi.nlm.nih.gov/pubmed/37256684 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e45554 %T TikTok and #OccupationalTherapy: Cross-sectional Study %A Chasca,Whitney %A Nerada,Samantha %A Zenone,Marco %A Barbic,Skye %+ Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC, V6T 2A1, Canada, 1 778 846 6134, skye.barbic@ubc.ca %K TikTok %K occupational therapy %K health professional %K knowledge translation %K social media %K education %K treatment %K community %K quality control %K information %K platform %D 2023 %7 19.5.2023 %9 Original Paper %J JMIR Form Res %G English %X 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. %M 37204836 %R 10.2196/45554 %U https://formative.jmir.org/2023/1/e45554 %U https://doi.org/10.2196/45554 %U http://www.ncbi.nlm.nih.gov/pubmed/37204836 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 10 %P e43383 %T Practical Considerations and Recommendations for “a Revised Hippocratic Oath for the Era of Digital Health” %A Hendricks-Sturrup,Rachele %A Nafie,Maryam %A Lu,Christine %+ Duke-Margolis Center for Health Policy, 1201 Pennsylvania Avenue NW, 5th Floor, Washington, DC, 20004, United States, 1 202 621 2800, rachele.hendricks.sturrup@duke.edu %K digital health %K Hippocratic Oath %K eHealth %K ethics %K digital divide %D 2022 %7 26.10.2022 %9 Commentary %J J Med Internet Res %G English %X The Hippocratic Oath (the “Oath”) is a longstanding body of ethical tenets that have undergone several amendments to accommodate changes and evolutions in the practice of medicine. In their recent perspective entitled, “A Revised Hippocratic Oath for the Era of Digital Health,” Meskó and Spiegel offered proposed amendments to the Oath to address both challenges and needs that follow digital health implementation in clinical practice. In this commentary, we offer additional thoughts and considerations to Meskó and Spiegel’s proposed amendments to accomplish two goals: (1) reflect on the shared goals and values of all digital health stakeholders and (2) drive home the focus on affirming patient choice, autonomy, and respect. %M 36287597 %R 10.2196/43383 %U https://www.jmir.org/2022/10/e43383 %U https://doi.org/10.2196/43383 %U http://www.ncbi.nlm.nih.gov/pubmed/36287597 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 10 %P e38949 %T Empowering Health Care Workers on Social Media to Bolster Trust in Science and Vaccination During the Pandemic: Making IMPACT Using a Place-Based Approach %A Jain,Shikha %A Dhaon,Serena R %A Majmudar,Shivani %A Zimmermann,Laura J %A Mordell,Lisa %A Walker,Garth %A Wallia,Amisha %A Akbarnia,Halleh %A Khan,Ali %A Bloomgarden,Eve %A Arora,Vineet M %+ Department of Medicine, University of Illinois at Chicago, 1740 W Taylor St, Chicago, IL, 60612, United States, 1 773 960 2567, sjain03@gmail.com %K misinformation %K COVID-19 %K place-based %K infodemic %K infographic %K social media %K advocacy %K infodemiology %K vaccination %K health care worker %K policy maker %K health policy %K community health %D 2022 %7 17.10.2022 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 35917489 %R 10.2196/38949 %U https://www.jmir.org/2022/10/e38949 %U https://doi.org/10.2196/38949 %U http://www.ncbi.nlm.nih.gov/pubmed/35917489 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 9 %P e39177 %T A Revised Hippocratic Oath for the Era of Digital Health %A Meskó,Bertalan %A Spiegel,Brennan %+ The Medical Futurist Institute, Povl Bang-Jensen u 2/B1 4/1, Budapest, 1118, Hungary, 36 703807260, berci@medicalfuturist.com %K hippocratic oath %K digital health %K eHealth %K future %K automation %K ethics %K viewpoint %K medical perspective %K physician perspective %K ethical %K digital divide %K artificial intelligence %K moral %D 2022 %7 7.9.2022 %9 Viewpoint %J J Med Internet Res %G English %X Physicians have been taking the Hippocratic Oath for centuries. The Oath contains a set of ethical rules designed to guide physicians through their profession; it articulates a set of true north principles that govern the practice of medicine. The Hippocratic Oath has undergone several revisions, most notably in 1948 by the World Medical Association. However, in an era of rapid change in medicine, we believe it is time to update the Oath with modest but meaningful additions so that it optimally reflects 21st century health care. The rise of digital health has dramatically changed the practice of medicine in a way that could not have been easily predicted at the time Hippocrates outlined his ethical principles of medicine. Digital health is a broad term that encompasses use of digital devices and platforms, including electronic health records, patient-provider portals, mobile health apps, wearable biosensors, artificial intelligence, social media platforms, and medical extended reality, to improve the process and outcomes of health care delivery. These technologies have driven a cultural transformation in the delivery of care. We offer modest suggestions to help prompt discussion and contemplation about the current Oath and its relevancy to our changing times. Our suggestions are not meant to be a definitive set of final recommendations. Rather, we propose new text that bodies such as the World Medical Association might consider integrating into an updated Oath, just as previous changes were adopted to ensure the Oath remains relevant and impactful for all physicians and their patients. %M 36069845 %R 10.2196/39177 %U https://www.jmir.org/2022/9/e39177 %U https://doi.org/10.2196/39177 %U http://www.ncbi.nlm.nih.gov/pubmed/36069845 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 3 %P e35585 %T Defining Potentially Unprofessional Behavior on Social Media for Health Care Professionals: Mixed Methods Study %A Vukušić Rukavina,Tea %A Machala Poplašen,Lovela %A Majer,Marjeta %A Relić,Danko %A Viskić,Joško %A Marelić,Marko %+ Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova 4, Zagreb, 10000, Croatia, 385 958065412, marko.marelic@snz.hr %K professionalism %K e-professionalism %K internet %K social media %K social networking %K medicine %K dental medicine %K health care professionals %K students %K faculty %D 2022 %7 9.8.2022 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 35758 %R 10.2196/35585 %U https://mededu.jmir.org/2022/3/e35585 %U https://doi.org/10.2196/35585 %U http://www.ncbi.nlm.nih.gov/pubmed/35758 %0 Journal Article %@ 2561-9128 %I JMIR Publications %V 5 %N 1 %P e34549 %T Worldwide Presence of National Anesthesia Societies on Four Major Social Networks in 2021: Observational Case Study %A Clavier,Thomas %A Occhiali,Emilie %A Guenet,Claire %A Vannier,Naurine %A Hache,Camille %A Compere,Vincent %A Selim,Jean %A Besnier,Emmanuel %+ Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, 1 rue de Germont, Rouen, 76000, France, 33 288891733, thomasclavier76@gmail.com %K social network, social media %K anaesthesia %K society %K Facebook %K Twitter %K Instagram %K YouTube %D 2022 %7 20.7.2022 %9 Viewpoint %J JMIR Perioper Med %G English %X 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. %M 35857379 %R 10.2196/34549 %U https://periop.jmir.org/2022/1/e34549 %U https://doi.org/10.2196/34549 %U http://www.ncbi.nlm.nih.gov/pubmed/35857379 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 5 %P e34302 %T A Virtual Community of Practice to Support Physician Uptake of a Novel Abortion Practice: Mixed Methods Case Study %A Dunn,Sheila %A Munro,Sarah %A Devane,Courtney %A Guilbert,Edith %A Jeong,Dahn %A Stroulia,Eleni %A Soon,Judith A %A Norman,Wendy V %+ Department of Family and Community Medicine, University of Toronto, 76 Grenville St, Toronto, ON, M5S 1B2, Canada, 1 416 323 6400 ext 4977, sheila.dunn@wchospital.ca %K mifepristone %K abortion %K community of practice %K virtual community of practice %K diffusion of innovation %K learning community %D 2022 %7 5.5.2022 %9 Original Paper %J J Med Internet Res %G English %X 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-Communauté 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 %M 35511226 %R 10.2196/34302 %U https://www.jmir.org/2022/5/e34302 %U https://doi.org/10.2196/34302 %U http://www.ncbi.nlm.nih.gov/pubmed/35511226 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 4 %P e31827 %T Using a Virtual Community of Practice to Support Stroke Best Practice Implementation: Mixed Methods Evaluation %A Linkewich,Elizabeth %A Quant,Sylvia %A Bechard,Lauren %A Donald,Michelle %+ North and East GTA Stroke Network, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada, 1 4164806100 ext 7300, beth.linkewich@sunnybrook.ca %K stroke %K rehabilitation %K knowledge translation %K implementation %K quality improvement %K evidence-based practice %K evaluation %K continuing education %K social media %K internet %K web-based learning %K allied health %D 2022 %7 27.4.2022 %9 Original Paper %J JMIR Form Res %G English %X Background: Successful best practice implementation is influenced by access to peer support and knowledge exchange. The Toronto Stroke Networks Virtual Community of Practice, a secure social media platform, is a knowledge translation tool supporting dissemination and adoption of stroke best practices for interprofessional stroke stakeholders. Objective: The aim of this study is to evaluate the use of a virtual community of practice (VCoP) in supporting regional stroke care best practice implementation in an urban context. Methods: A mixed methods approach was used. Qualitative data were collected through focus groups and interviews with stroke care provider members of the VCoP working in acute and rehabilitation settings. Thematic analysis was completed, and the Wenger Value Creation Model and developmental evaluation were used to reflect practice change. Quantitative data were collected and analyzed using website analytics on VCoP use. Results: A year after implementation, the VCoP had 379 members. Analysis of web analytics data and transcripts from focus groups and interviews conducted with 26 VCoP members indicated that the VCoP provided immediate value in supporting user networking, community activities, and interactions. Skill acquisition and changes in perspective acquired through discussion and project work on the VCoP were valued by members, with potential value for supporting practice change. Learning about new stroke best practices through the VCoP was a starting point for individuals and teams to contemplate change. Conclusions: These findings suggest that the VCoP supports the early stages of practice change and stroke best practice implementation. Future research should examine how VCoPs can support higher levels of value creation for implementing stroke best practices. %M 35475730 %R 10.2196/31827 %U https://formative.jmir.org/2022/4/e31827 %U https://doi.org/10.2196/31827 %U http://www.ncbi.nlm.nih.gov/pubmed/35475730 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 3 %P e32800 %T Tackling the Burden of Electronic Health Record Use Among Physicians in a Mental Health Setting: Physician Engagement Strategy %A Tajirian,Tania %A Jankowicz,Damian %A Lo,Brian %A Sequeira,Lydia %A Strudwick,Gillian %A Almilaji,Khaled %A Stergiopoulos,Vicky %+ Information Management Group, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON, M6J 1H4, Canada, 1 416 535 8501 ext 30515, Tania.Tajirian@camh.ca %K burnout %K organizational strategy %K electronic health record use %K clinical informatics %K medical informatics %D 2022 %7 8.3.2022 %9 Viewpoint %J J Med Internet Res %G English %X The burden associated with using the electronic health record system continues to be a critical issue for physicians and is potentially contributing to physician burnout. At a large academic mental health hospital in Canada, we recently implemented a Physician Engagement Strategy focused on reducing the burden of electronic health record use through close collaboration with clinical leadership, information technology leadership, and physicians. Built on extensive stakeholder consultation, this strategy highlights initiatives that we have implemented (or will be implementing in the near future) under four components: engage, inspire, change, and measure. In this viewpoint paper, we share our process of developing and implementing the Physician Engagement Strategy and discuss the lessons learned and implications of this work. %M 35258473 %R 10.2196/32800 %U https://www.jmir.org/2022/3/e32800 %U https://doi.org/10.2196/32800 %U http://www.ncbi.nlm.nih.gov/pubmed/35258473 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e25654 %T Audience of Academic Otolaryngology on Twitter: Cross-sectional Study %A Xie,Deborah X %A Boss,Emily F %A Stewart,C Matthew %+ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, 601 N Caroline Street, Baltimore, MD, 21231, United States, 1 410 955 3492, cstewa16@jhmi.edu %K Twitter %K otolaryngology %K residency %K medical education %K social media %K internet %D 2021 %7 8.12.2021 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 34889748 %R 10.2196/25654 %U https://mededu.jmir.org/2021/4/e25654 %U https://doi.org/10.2196/25654 %U http://www.ncbi.nlm.nih.gov/pubmed/34889748 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 11 %P e26123 %T Examination of a Canada-Wide Collaboration Platform for Order Sets: Retrospective Analysis %A Javidan,Arshia Pedram %A Brand,Allan %A Cameron,Andrew %A D'Ovidio,Tommaso %A Persaud,Martin %A Lewis,Kirsten %A O'Connor,Chris %+ Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto General Hospital, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada, 1 416 340 3131, arshia.javidan@mail.utoronto.ca %K evidence-based medicine %K health informatics %K knowledge translation %K order sets %K Web 2.0 %D 2021 %7 29.11.2021 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 34847055 %R 10.2196/26123 %U https://www.jmir.org/2021/11/e26123 %U https://doi.org/10.2196/26123 %U http://www.ncbi.nlm.nih.gov/pubmed/34847055 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 5 %N 11 %P e33335 %T A Virtual Community for Disability Advocacy: Development of a Searchable Artificial Intelligence–Supported Platform %A El Morr,Christo %A Maret,Pierre %A Muhlenbach,Fabrice %A Dharmalingam,Dhayananth %A Tadesse,Rediet %A Creighton,Alexandra %A Kundi,Bushra %A Buettgen,Alexis %A Mgwigwi,Thumeka %A Dinca-Panaitescu,Serban %A Dua,Enakshi %A Gorman,Rachel %+ School of Health Policy and Management, Faculty of Health, York University, Stong College Room 306, 4700 Keele St, Toronto, ON, M3J 1P3, Canada, 1 4167362100, elmorr@yorku.ca %K virtual community %K machine learning %K Semantic Web %K natural language processing %K web intelligence %K health informatics %K Wikibase %K disability rights %K human rights %K CRPD %K equity %K community %K disability %K ethics %K rights %K pilot %K platform %D 2021 %7 5.11.2021 %9 Original Paper %J JMIR Form Res %G English %X Background: The lack of availability of disability data has been identified as a major challenge hindering continuous disability equity monitoring. It is important to develop a platform that enables searching for disability data to expose systemic discrimination and social exclusion, which increase vulnerability to inequitable social conditions. Objective: Our project aims to create an accessible and multilingual pilot disability website that structures and integrates data about people with disabilities and provides data for national and international disability advocacy communities. The platform will be endowed with a document upload function with hybrid (automated and manual) paragraph tagging, while the querying function will involve an intelligent natural language search in the supported languages. Methods: We have designed and implemented a virtual community platform using Wikibase, Semantic Web, machine learning, and web programming tools to enable disability communities to upload and search for disability documents. The platform data model is based on an ontology we have designed following the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The virtual community facilitates the uploading and sharing of validated information, and supports disability rights advocacy by enabling dissemination of knowledge. Results: Using health informatics and artificial intelligence techniques (namely Semantic Web, machine learning, and natural language processing techniques), we were able to develop a pilot virtual community that supports disability rights advocacy by facilitating uploading, sharing, and accessing disability data. The system consists of a website on top of a Wikibase (a Semantic Web–based datastore). The virtual community accepts 4 types of users: information producers, information consumers, validators, and administrators. The virtual community enables the uploading of documents, semiautomatic tagging of their paragraphs with meaningful keywords, and validation of the process before uploading the data to the disability Wikibase. Once uploaded, public users (information consumers) can perform a semantic search using an intelligent and multilingual search engine (QAnswer). Further enhancements of the platform are planned. Conclusions: The platform ontology is flexible and can accommodate advocacy reports and disability policy and legislation from specific jurisdictions, which can be accessed in relation to the CRPD articles. The platform ontology can be expanded to fit international contexts. The virtual community supports information upload and search. Semiautomatic tagging and intelligent multilingual semantic search using natural language are enabled using artificial intelligence techniques, namely Semantic Web, machine learning, and natural language processing. %M 34738910 %R 10.2196/33335 %U https://formative.jmir.org/2021/11/e33335 %U https://doi.org/10.2196/33335 %U http://www.ncbi.nlm.nih.gov/pubmed/34738910 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 10 %P e30217 %T The State of Mind of Health Care Professionals in Light of the COVID-19 Pandemic: Text Analysis Study of Twitter Discourses %A Elyashar,Aviad %A Plochotnikov,Ilia %A Cohen,Idan-Chaim %A Puzis,Rami %A Cohen,Odeya %+ Software and Information Systems Engineering, Ben-Gurion University of the Negev, Rager st. POB 653, Beer Sheva, 8410501, Israel, 972 544764010, puzis@bgu.ac.il %K health care professionals %K Twitter %K COVID-19 %K topic analysis %K emotion analysis %K sentiment analysis %K social media %K machine learning %K active learning %D 2021 %7 22.10.2021 %9 Original Paper %J J Med Internet Res %G English %X Background: The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Health care professionals (HCPs) are at the core of pandemic response and are among the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects caused by managing a long-lasting emergency with a lack of resources and under complicated personal concerns. However, there are a lack of longitudinal studies that investigate the HCP population. Objective: The aim of this study was to analyze the state of mind of HCPs as expressed in online discussions published on Twitter in light of the COVID-19 pandemic, from the onset of the pandemic until the end of 2020. Methods: The population for this study was selected from followers of a few hundred Twitter accounts of health care organizations and common HCP points of interest. We used active learning, a process that iteratively uses machine learning and manual data labeling, to select the large-scale population of Twitter accounts maintained by English-speaking HCPs, focusing on individuals rather than official organizations. We analyzed the topics and emotions in their discourses during 2020. The topic distributions were obtained using the latent Dirichlet allocation algorithm. We defined a measure of topic cohesion and described the most cohesive topics. The emotions expressed in tweets during 2020 were compared to those in 2019. Finally, the emotion intensities were cross-correlated with the pandemic waves to explore possible associations between the pandemic development and emotional response. Results: We analyzed the timelines of 53,063 Twitter profiles, 90% of which were maintained by individual HCPs. Professional topics accounted for 44.5% of tweets by HCPs from January 1, 2019, to December 6, 2020. Events such as the pandemic waves, US elections, or the George Floyd case affected the HCPs’ discourse. The levels of joy and sadness exceeded their minimal and maximal values from 2019, respectively, 80% of the time (P=.001). Most interestingly, fear preceded the pandemic waves, in terms of the differences in confirmed cases, by 2 weeks with a Spearman correlation coefficient of ρ(47 pairs)=0.340 (P=.03). Conclusions: Analyses of longitudinal data over the year 2020 revealed that a large fraction of HCP discourse is directly related to professional content, including the increase in the volume of discussions following the pandemic waves. The changes in emotional patterns (ie, decrease in joy and increase in sadness, fear, and disgust) during the year 2020 may indicate the utmost importance in providing emotional support for HCPs to prevent fatigue, burnout, and mental health disorders during the postpandemic period. The increase in fear 2 weeks in advance of pandemic waves indicates that HCPs are in a position, and with adequate qualifications, to anticipate pandemic development, and could serve as a bottom-up pathway for expressing morbidity and clinical situations to health agencies. %M 34550899 %R 10.2196/30217 %U https://www.jmir.org/2021/10/e30217 %U https://doi.org/10.2196/30217 %U http://www.ncbi.nlm.nih.gov/pubmed/34550899 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 22 %N 9 %P e18062 %T Examining Patterns of Information Exchange and Social Support in a Web-Based Health Community: Exponential Random Graph Models %A Liu,Xuan %A Jiang,Shan %A Sun,Min %A Chi,Xiaotong %+ East China University of Science and Technology, 130 Meilong Rd East China University of Science and Technology, Shanghai, China, 86 86 21 64253177, xuanliu@ecust.edu.cn %K web-based health communities %K information exchange %K social support %K ERGM %D 2020 %7 29.9.2020 %9 Original Paper %J J Med Internet Res %G English %X Background: Although an increasing number of studies have attempted to understand how people interact with others in web-based health communities, studies focusing on understanding individuals’ patterns of information exchange and social support in web-based health communities are still limited. In this paper, we discuss how patients’ social interactions develop into social networks based on a network exchange framework and empirically validate the framework in web-based health care community contexts. Objective: This study aims to explore various patterns of information exchange and social support in web-based health care communities and identify factors that affect such patterns. Methods: Using social network analysis and text mining techniques, we empirically validated a network exchange framework on a 10-year data set collected from a popular web-based health community. A reply network was extracted from the data set, and exponential random graph models were used to discover patterns of information exchange and social support from the network. Results: Results showed that reciprocated information exchange was common in web-based health communities. The homophily effect existed in general conversations but was weakened when exchanging knowledge. New members in web-based health communities tended to receive more support. Furthermore, polarized sentiment increases the chances of receiving replies, and optimistic users play an important role in providing social support to the entire community. Conclusions: This study complements the literature on network exchange theories and contributes to a better understanding of social exchange patterns in the web-based health care context. Practically, this study can help web-based patients obtain information and social support more effectively. %M 32990628 %R 10.2196/18062 %U http://www.jmir.org/2020/9/e18062/ %U https://doi.org/10.2196/18062 %U http://www.ncbi.nlm.nih.gov/pubmed/32990628 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 22 %N 7 %P e18569 %T Consequences of Gift Giving in Online Health Communities on Physician Service Quality: Empirical Text Mining Study %A Peng,Li %A Wang,Yanan %A Chen,Jing %+ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Qiaokou District, Wuhan, Hubei, China, 86 15972965520, yanan_wang2020@163.com %K online health community %K gift giving %K affective/instrumental gifts %K service quality %K bedside manner %K physicians %K physician-patient relationship %D 2020 %7 30.7.2020 %9 Original Paper %J J Med Internet Res %G English %X Background: Gift giving, which has been a heavily debated topic in health care for many years, is considered as a way of expressing gratitude and to be beneficial for the physician-patient relationship within a reasonable range. However, not much work has been done to examine the influence of gift giving on physicians’ service quality, especially in the online health care environment. Objective: This study addressed the consequences of gift giving by mining and analyzing the dynamic physician-patient interaction processes in an online health community. Specifically, gift types (affective or instrumental) based on the motivations and physician-patient tie strength were carefully considered to account for differences in physicians’ service quality. Methods: The dynamic interaction processes (involving 3154 gifts) between 267 physicians and 14,187 patients from a well-known online health community in China (haodf.com) were analyzed to obtain empirical results. Results: Our results reveal that patient gift giving inspires physicians to improve their service quality as measured by physicians’ more detailed responses and improved bedside manner, and the degree of influence varied according to the strength of the physician-patient tie. Moreover, affective gifts and instrumental gifts had different effects in improving physicians’ service quality online. Conclusions: This study is among the first to explore gift giving in online health communities providing both important theoretical and practical contributions. All of our results suggest that gift giving online is of great significance to promoting effective physician-patient communication and is conducive to the relief of physician-patient conflicts. %M 32729834 %R 10.2196/18569 %U http://www.jmir.org/2020/7/e18569/ %U https://doi.org/10.2196/18569 %U http://www.ncbi.nlm.nih.gov/pubmed/32729834 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 22 %N 3 %P e16728 %T Understanding Patient Anxieties in the Social Media Era: Qualitative Analysis and Natural Language Processing of an Online Male Infertility Community %A Osadchiy,Vadim %A Mills,Jesse Nelson %A Eleswarapu,Sriram Venkata %+ Division of Andrology, Department of Urology, David Geffen School of Medicine, University of California,, 10944 Le Conte Ave, Ueberroth #3361, Los Angeles, CA, 90025, United States, 1 3107943058, seleswarapu@mednet.ucla.edu %K social media %K infertility, male %K online social networking %K Reddit %K discussion board %D 2020 %7 10.3.2020 %9 Original Paper %J J Med Internet Res %G English %X Background: Couples struggling with infertility are increasingly turning to the internet for infertility-related content and to connect with others. Most of the published data on infertility and the internet only address the experiences of women, with limited studies focusing exclusively on internet discussions on male factor infertility. Objective: The aim of this study was to understand the concerns and experiences of discussants on an online male infertility community and to provide insight into their perceptions of interactions with health care professionals. Methods: Using the large-scale data analytics tool BigQuery, we extracted all posts in the r/MaleInfertility community (877 members) of the social media website and discussion board Reddit from November 2017 to October 2018. We performed a qualitative thematic analysis and quantitative semantic analysis using Language Inquiry and Word Count 2015 of the extracted posts to identify dominant themes and subthemes of discussions. Descriptive statistics and semantic analytic Z-scores were computed. Results: From the analysis of 97 posts, notable themes and subthemes emerged: 70 (72%) posts shared personal experiences, including feeling emasculated or isolated or describing a negative (28/97, 29%), positive (13/97, 13%), or neutral (56/97, 58%) experience with a health care professional; 19% (18/97) of the posts posed questions about personal semen analysis results. On the basis of semantic analysis, posts by men had higher authenticity scores (Z=3.44; P<.001), suggesting more honest or personal texts, but lower clout scores (Z=4.57; P<.001), suggesting a more tentative or anxious style of writing, compared with posts by women. Conclusions: To our knowledge, this study represents the first evaluation of a social media community focused exclusively on male infertility using mixed methodology. These results suggest a role for physicians on social media to engage with patients and connect them to accurate resources, in addition to opportunities to improve in-office patient education. %M 32154785 %R 10.2196/16728 %U http://www.jmir.org/2020/3/e16728/ %U https://doi.org/10.2196/16728 %U http://www.ncbi.nlm.nih.gov/pubmed/32154785 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 21 %N 11 %P e14068 %T Why Health Care Professionals Belong to an Intensive Care Virtual Community: Qualitative Study %A Rolls,Kaye Denise %A Hansen,Margaret Mary %A Jackson,Debra %A Elliott,Doug %+ Centre for Applied Nursing Research, University of Western Sydney, 1 Campbell Street, Liverpool, 2170, Australia, 61 2 8738 9390, kaye.rolls@westernsydney.edu.au %K social media %K focus groups %K physician %K nurse %K intensive care %K innovation diffusion %K scholarly communication %D 2019 %7 5.11.2019 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 31687936 %R 10.2196/14068 %U https://www.jmir.org/2019/11/e14068 %U https://doi.org/10.2196/14068 %U http://www.ncbi.nlm.nih.gov/pubmed/31687936 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 4 %N 2 %P e11140 %T Expanding Opportunities for Professional Development: Utilization of Twitter by Early Career Women in Academic Medicine and Science %A Lewis,Jaime D %A Fane,Kathleen E %A Ingraham,Angela M %A Khan,Ayesha %A Mills,Anne M %A Pitt,Susan C %A Ramo,Danielle %A Wu,Roseann I %A Pollart,Susan M %+ Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267, United States, 1 513 584 8900, jaime.lewis@uc.edu %K female %K leadership %K social media %K academic success %K professional development %D 2018 %7 23.07.2018 %9 Viewpoint %J JMIR Med Educ %G English %X The number of women entering medical school and careers in science is increasing; however, women remain the minority of those in senior faculty and leadership positions. Barriers contributing to the shortage of women in academics and academic leadership are numerous, including a shortage of role models and mentors. Thus, achieving equity in a timelier manner will require more than encouraging women to pursue these fields of study or waiting long enough for those in the pipelines to be promoted. Social media provides new ways to connect and augments traditional forms of communication. These alternative avenues may allow women in academic medicine to obtain the support they are otherwise lacking. In this perspective, we reflect on the role of Twitter as a supplemental method for navigating the networks of academic medicine. The discussion includes the use of Twitter to obtain (1) access to role models, (2) peer-to-peer interactions, and continuous education, and (3) connections with those entering the pipeline—students, trainees, and mentees. This perspective also offers suggestions for developing a Twitter network. By participating in the “Twittersphere,” women in academic medicine may enhance personal and academic relationships that will assist in closing the gender divide. %M 30037788 %R 10.2196/11140 %U http://mededu.jmir.org/2018/2/e11140/ %U https://doi.org/10.2196/11140 %U http://www.ncbi.nlm.nih.gov/pubmed/30037788 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 20 %N 2 %P e34 %T How Knowledge Is Constructed and Exchanged in Virtual Communities of Physicians: Qualitative Study of Mindlines Online %A Wieringa,Sietse %A Engebretsen,Eivind %A Heggen,Kristin %A Greenhalgh,Trisha %+ Evidence-Based Health Care Program, Department of Continuing Education, University of Oxford, Rewley House 1, Wellington Square, Oxford, OX1 2JA, United Kingdom, 44 7549911036, sietse.wieringa@kellogg.ox.ac.uk %K knowledge management %K translational medical research %K guidelines as topic %K evidence-based medicine %K evidence-based practice %D 2018 %7 02.02.2018 %9 Original Paper %J J Med Internet Res %G English %X Background: As a response to the criticisms evidence-based practice currently faces, groups of health care researchers and guideline makers have started to call for the appraisal and inclusion of different kinds of knowledge in guideline production (other than randomized controlled trials [RCTs]) to better link with the informal knowledge used in clinical practice. In an ethnographic study, Gabbay and Le May showed that clinicians in everyday practice situations do not explicitly or consciously use guidelines. Instead, they use mindlines: collectively shared, mostly tacit knowledge that is shaped by many sources, including accumulated personal experiences, education (formal and informal), guidance, and the narratives about patients that are shared among colleagues. In this study on informal knowledge, we consider virtual networks of clinicians as representative of the mindlines in the wider medical community, as holders of knowledge, as well as catalysts of knowing. Objective: The aim of this study was to explore how informal knowledge and its creation in communities of clinicians can be characterized as opposed to the more structured knowledge produced in guideline development. Methods: This study included a qualitative study of postings on three large virtual networks for physicians in the United Kingdom, the Netherlands, and Norway, taking the topic of statins as a case study and covering more than 1400 posts. Data were analyzed thematically with reference to theories of collaborative knowledge construction and communities of practice. Results: The dataset showed very few postings referring to, or seeking to adhere to, explicit guidance and recommendations. Participants presented many instances of individual case narratives that highlighted quantitative test results and clinical examination findings. There was an emphasis on outliers and the material, regulatory, and practical constraints on knowledge use by clinicians. Participants conveyed not-so-explicit knowledge as tacit and practical knowledge and used a prevailing style of pragmatic reasoning focusing on what was likely to work in a particular case. Throughout the discussions, a collective conceptualization of statins was generated and reinforced in many contexts through stories, jokes, and imagery. Conclusions: Informal knowledge and knowing in clinical communities entail an inherently collective dynamic practice that includes explicit and nonexplicit components. It can be characterized as knowledge-in-context in practice, with a strong focus on casuistry. Validity of knowledge appears not to be based on criteria of consensus, coherence, or correspondence but on a more polyphonic understanding of truth. We contend that our findings give enough ground for further research on how exploring mindlines of clinicians online could help improve guideline development processes. %M 29396385 %R 10.2196/jmir.8325 %U https://www.jmir.org/2018/2/e34/ %U https://doi.org/10.2196/jmir.8325 %U http://www.ncbi.nlm.nih.gov/pubmed/29396385 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 19 %N 7 %P e252 %T Preliminary Evidence for the Emergence of a Health Care Online Community of Practice: Using a Netnographic Framework for Twitter Hashtag Analytics %A Roland,Damian %A Spurr,Jesse %A Cabrera,Daniel %+ SAPPHIRE Group, Health Sciences, Leicester University, Centre for Medicine, Leicester, LE1 7RH, United Kingdom, 44 7727158213, dr98@le.ac.uk %K social media %K network %K community networks %K community of practice %K #FOAMed %K Twitter %D 2017 %7 14.07.2017 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 28710054 %R 10.2196/jmir.7072 %U http://www.jmir.org/2017/7/e252/ %U https://doi.org/10.2196/jmir.7072 %U http://www.ncbi.nlm.nih.gov/pubmed/28710054 %0 Journal Article %@ 23696893 %I JMIR Publications Inc. %V 1 %N 1 %P e11 %T Professional Virtual Communities for Health Care Implementers: Impact of Participation on Practice %A Connelly,Marie %A Beals,Aaron %A VanDerlip,Aaron %A Singaraju,Koundinya %A Weintraub,Rebecca L %+ The Global Health Delivery Project at Harvard University, 75 Francis Street, Boston, MA, 02115, United States, 1 703 638 4407, marie@globalhealthdelivery.org %K Professional Virtual Communities %K Health care delivery %K Knowledge dissemination %K Communities of Practice %K Online Communities %D 2015 %7 27.10.2015 %9 Abstract %J iProc %G English %X Background: Since 2008, GHDonline.org has provided a platform of professional virtual communities (PVCs) for health care implementers around the world to connect and discuss delivery challenges. Initially focused on low-resource settings internationally, GHDonline received funding from the Agency for Healthcare Research and Quality (AHRQ) in 2013 to expand the platform and launch the US Communities Initiative (USCI), PVCs for US-based health care professionals working with underserved populations. Objective: Over the course of the three-year funding period, we established four PVCs focused on population health, quality and safety, costs of care, and delivery innovations. We aim to develop a greater understanding of the challenges facing US health care professionals while also facilitating the dissemination and translation of evidence-based resources and novel approaches to delivering care. We seek to understand the impact that participation in these PVCs has on the implementation and integration of best practices in care delivery around the country. Methods: Each PVC is supported by a team of expert moderators who guide and shape community goals, content, and programming. GHDonline works closely with these moderators to organize virtual Expert Panels (week-long, asynchronous online conferences), which facilitate the spread of evidence-based resources and, through dialogue with experts, educate members on strategies for adapting these tools for a range of delivery settings. Our impact evaluation includes three methods: analysis of site data, member surveys, and phone interviews. Site data shows the scope and engagement of readership in the PVCs. Surveys, fielded before and after each Expert Panel, assess members’ knowledge of and ability to implement relevant best practices. Individual interviews identify examples of PVC participation impacting practice, as well as opportunities to improve the PVCs themselves. Results: While evaluation efforts are ongoing, current survey data shows a majority of respondents, 91% (149/163), found information shared in Expert Panels relevant to the populations they serve. A strong majority, 73% (127/175), report an intention to make changes in their practice, and 47% (81/172) report implementing changes based on knowledge gained through PVC participation. We randomly selected 500 active members to participate in interviews and have completed 50 interviews to date. A significant majority of interviewees, 82% (41/50), recommended GHDonline to colleagues, and many, 60% (30/50), indicated they are making changes in their practice based on information gained through PVC participation. Conclusions: Recognizing the limitations of self-reported surveys and interview responses, and the preliminary nature of our current findings, we believe these results show strong potential for PVCs to facilitate dissemination and translation of evidence-based practices and improve care delivery in the US. Trial Registration: Not applicable. %R 10.2196/iproc.4695 %U http://www.iproc.org/2015/1/e11/ %U https://doi.org/10.2196/iproc.4695 %0 Journal Article %@ 1438-8871 %I JMIR Publications Inc. %V 16 %N 7 %P e185 %T Virtual Communities of Practice: Overcoming Barriers of Time and Technology %A Walsh,Kieran %A Barnett,Stephen %+ BMJ Learning, Tavistock Square, London, WC1H 9JR, United Kingdom, 44 7985755333, kmwalsh@bmj.com %K medical education %K community of practice %K time %K technology %D 2014 %7 29.07.2014 %9 Letter to the Editor %J J Med Internet Res %G English %X %M 25090622 %R 10.2196/jmir.3400 %U http://www.jmir.org/2014/7/e185/ %U https://doi.org/10.2196/jmir.3400 %U http://www.ncbi.nlm.nih.gov/pubmed/25090622 %0 Journal Article %@ 14388871 %I JMIR Publications Inc. %V 16 %N 3 %P e83 %T Implementing a Virtual Community of Practice for Family Physician Training: A Mixed-Methods Case Study %A Barnett,Stephen %A Jones,Sandra C %A Caton,Tim %A Iverson,Don %A Bennett,Sue %A Robinson,Laura %+ General Practice Academic Unit, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, 2522, Australia, 61 42214613, sbarnett@uow.edu.au %K community of practice %K virtual community of practice %K general practice %K family physician %K training %K medical graduate %K education %K social media %D 2014 %7 12.03.2014 %9 Original Paper %J J Med Internet Res %G English %X Background: GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation. Objective: The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation. Methods: The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation. Results: Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%). Conclusions: The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context. %M 24622292 %R 10.2196/jmir.3083 %U http://www.jmir.org/2014/3/e83/ %U https://doi.org/10.2196/jmir.3083 %U http://www.ncbi.nlm.nih.gov/pubmed/24622292 %0 Journal Article %@ 14388871 %I JMIR Publications Inc. %V 16 %N 2 %P e49 %T 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 %A Frisch,Noreen %A Atherton,Pat %A Borycki,Elizabeth %A Mickelson,Grace %A Cordeiro,Jennifer %A Novak Lauscher,Helen %A Black,Agnes %+ School of Nursing, Faculty of Human and Social Development, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, V8W 2Y2, Canada, 1 250 721 7953, nfrisch@uvic.ca %K social networking %K social media %K nursing %K health services %K research %K education %D 2014 %7 21.02.2014 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 24566806 %R 10.2196/jmir.3018 %U http://www.jmir.org/2014/2/e49/ %U https://doi.org/10.2196/jmir.3018 %U http://www.ncbi.nlm.nih.gov/pubmed/24566806 %0 Journal Article %@ 14388871 %I JMIR Publications Inc. %V 15 %N 5 %P e92 %T Perceptions of Family Physician Trainees and Trainers Regarding the Usefulness of a Virtual Community of Practice %A Barnett,Stephen %A Jones,Sandra C %A Bennett,Sue %A Iverson,Don %A Bonney,Andrew %+ General Practice Academic Unit, Graduate School of Medicine, University of Wollongong, Wollongong, 2522, Australia, 61 2 4221 ext 4613, sbarnett@uow.edu.au %K community of practice %K virtual community of practice %K general practice %K family physician %K training %K education %K medical graduate %K social media %D 2013 %7 10.05.2013 %9 Original Paper %J J Med Internet Res %G English %X Background: Training for Australian general practice, or family medicine, can be isolating, with registrars (residents or trainees) moving between rural and urban environments, and between hospital and community clinic posts. Virtual communities of practice (VCoPs), groups of people sharing knowledge about their domain of practice online and face-to-face, may have a role in overcoming the isolation associated with general practice training. Objective: This study explored whether Australian general practice registrars and their supervisors (trainers) would be able to use, and would be interested in using, a VCoP in the form of a private online network for work and training purposes. It also sought to understand the facilitators and barriers to intention to use such a community, and considers whether any of these factors may be modifiable. Methods: A survey was developed assessing computer, Internet, and social media access and usage, confidence, perceived usefulness, and barriers, facilitators, and intentions to use a private online network for training purposes. The survey was sent by email link to all 139 registrars and 224 supervisors in one of Australia’s 17 general practice training regions. Complete and usable responses were received from 131 participants (response rate=0.4). Results: Most respondents had access to broadband at home (125/131, 95.4%) and at work (130/131, 99.2%). Registrars were more likely to spend more than 2 hours on the Internet (P=.03), and to use social media sites for nonwork purposes (P=.01). On a 5-point Likert scale, confidence was high (mean 3.93, SD 0.63) and was negatively associated with higher age (P=.04), but not associated with training stage. Social media confidence was lower, with registrars more confident than supervisors for almost all social media activities. On a 5-point Likert scale, overall usefulness was scored positively (n=123, mean 3.63, SD 0.74), and was not significantly associated with age or training level. The main concerns of respondents were worries about privacy (registrar: 61/81, 75.3%; supervisor: 30/50, 60.0%) and insufficient time (registrar: 41/81, 50.6%; supervisor: 36/50, 72.0%). Using a multivariate generalized linear regression model, training stage and perceived usefulness were positively predictive, and concerns about privacy and time were negatively predictive of intention to use a private online network. Conclusions: General practice registrars and supervisors are interested in using a private online network, or VCoP, for work and training purposes. Important considerations are the extent to which concerns such as privacy and usefulness may be overcome by training and support to offset some other concerns, such as time barriers. Participants at an early stage in their training are more receptive to using an online network. More senior registrars and supervisors may benefit from more training and promotion of the online network to improve their receptiveness. %M 23666237 %R 10.2196/jmir.2555 %U http://www.jmir.org/2013/5/e92/ %U https://doi.org/10.2196/jmir.2555 %U http://www.ncbi.nlm.nih.gov/pubmed/23666237 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 14 %N 6 %P e170 %T Applying Social Network Analysis to Understand the Knowledge Sharing Behaviour of Practitioners in a Clinical Online Discussion Forum %A Stewart,Samuel Alan %A Abidi,Syed Sibte Raza %+ NICHE Research Group, Faculty of Computer Science, Dalhousie University, 6050 University Ave., Halifax, NS, B3H 4R2, Canada, 1 902 225 8747, sam.stewart@dal.ca %K Web 2.0 %K health knowledge %K attitudes %K practice %K knowledge management %K information dissemination %K pain %K pediatrics %K pediatric hospitals %K education %K professional %K electronic mail %D 2012 %7 04.12.2012 %9 Original Paper %J J Med Internet Res %G English %X 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. %M 23211783 %R 10.2196/jmir.1982 %U http://www.jmir.org/2012/6/e170/ %U https://doi.org/10.2196/jmir.1982 %U http://www.ncbi.nlm.nih.gov/pubmed/23211783