Harnessing Google Health Trends API Data for Epidemiologic Research.

Interest in using internet search data, such as that from the Google Health Trends Application Programming Interface (GHT-API), to measure epidemiologically relevant exposures or health outcomes is growing due to their accessibility and timeliness. Researchers input search term(s), geography and time period, and the GHT-API returns a scaled probability of that search term, given all searches within the specified geo-time period. In this study, we detail a method for using these data to measure a construct of interest in five iterative steps: first, identify phrases the target population may use to search for the construct of interest; second, refine candidate search phrases with incognito Google searches to improve sensitivity and specificity; third, craft the GHT-API search term(s) by combining the refined phrases; fourth, test search volume and choose geographic and temporal scales; and fifth, retrieve and average multiple samples to stabilize estimates and address missingness. An optional sixth step involves accounting for changes in total search volume by normalizing. We present a case study examining weekly state-level child abuse searches in the United States during the COVID-19 pandemic (January 2018-August 2020) as an application of this method and describe limitations.

US shelter in place policies and child abuse Google search volume during the COVID-19 pandemic.

The COVID-19 pandemic has led to unemployment, school closures, movement restrictions, and social isolation, all of which are child abuse risk factors. Our objective was to estimate the effect of COVID-19 shelter in place (SIP) policies on child abuse as captured by Google searches. We applied a differences-in-differences design to estimate the effect of SIP on child abuse search volume. We linked state-level SIP policies to outcome data from the Google Health Trends Application Programming Interface. The outcome was searches for child abuse-related phrases as a scaled proportion of total searches for each state-week between December 31, 2017 and June 14, 2020. Between 914 and 1512 phrases were included for each abuse subdomain (physical, sexual, and emotional). Eight states and DC were excluded because of suppressed outcome data. Of the remaining states, 38 introduced a SIP policy between March 19, 2020 and April 7, 2020 and 4 states did not. The introduction of SIP generally led to no change, except for a slight reduction in child abuse search volume in weeks 8-10 post-SIP introduction, net of changes experienced by states that did not introduce SIP at the same time. We did not find strong evidence for an effect of SIP on child abuse searches. However, an increase in total search volume during the pandemic that may be differential between states with and without SIP policies could have biased these findings. Future work should examine the effect of SIP at the individual and population level using other data sources.

The impact of COVID-19 on disease epidemiology, family dynamics, and social justice in Minnesota: All that you cannot see.

Objective: The COVID-19 pandemic presented a challenge to established seed grant funding mechanisms aimed at fostering collaboration in child health research between investigators at the University of Minnesota (UMN) and Children's Hospitals and Clinics of Minnesota (Children's MN). We created a "rapid response," small grant program to catalyze collaborations in child health COVID-19 research. In this paper, we describe the projects funded by this mechanism and metrics of their success. Methods: Using seed funds from the UMN Clinical and Translational Science Institute, the UMN Medical School Department of Pediatrics, and the Children's Minnesota Research Institute, a rapid response request for applications (RFAs) was issued based on the stipulations that the proposal had to: 1) consist of a clear, synergistic partnership between co-PIs from the academic and community settings; and 2) that the proposal addressed an area of knowledge deficit relevant to child health engendered by the COVID-19 pandemic. Results: Grant applications submitted in response to this RFA segregated into three categories: family fragility and disruption exacerbated by COVID-19; knowledge gaps about COVID-19 disease in children; and optimizing pediatric care in the setting of COVID-19 pandemic restrictions. A series of virtual workshops presented research results to the pediatric community. Several manuscripts and extramural funding awards underscored the success of the program. Conclusions: A "rapid response" seed funding mechanism enabled nascent academic-community research partnerships during the COVID-19 pandemic. In the context of the rapidly evolving landscape of COVID-19, flexible seed grant programs can be useful in addressing unmet needs in pediatric health.

Excess Google Searches for Child Abuse and Intimate Partner Violence During the COVID-19 Pandemic: Infoveillance Approach.

BACKGROUND: The COVID-19 pandemic has created environments with increased risk factors for household violence, such as unemployment and financial uncertainty. At the same time, it led to the introduction of policies to mitigate financial uncertainty. Further, it hindered traditional measurements of household violence. OBJECTIVE: Using an infoveillance approach, our goal was to determine if there were excess Google searches related to exposure to child abuse, intimate partner violence (IPV), and child-witnessed IPV during the COVID-19 pandemic and if any excesses are temporally related to shelter-in-place and economic policies. METHODS: Data on relative search volume for each violence measure was extracted using the Google Health Trends application programming interface for each week from 2017 to 2020 for the United States. Using linear regression with restricted cubic splines, we analyzed data from 2017 to 2019 to characterize the seasonal variation shared across prepandemic years. Parameters from prepandemic years were used to predict the expected number of Google searches and 95% prediction intervals (PI) for each week in 2020. Weeks with searches above the upper bound of the PI are in excess of the model's prediction. RESULTS: Relative search volume for exposure to child abuse was greater than expected in 2020, with 19% (10/52) of the weeks falling above the upper bound of the PI. These excesses in searches began a month after the Pandemic Unemployment Compensation program ended. Relative search volume was also heightened in 2020 for child-witnessed IPV, with 33% (17/52) of the weeks falling above the upper bound of the PI. This increase occurred after the introduction of shelter-in-place policies. CONCLUSIONS: Social and financial disruptions, which are common consequences of major disasters such as the COVID-19 pandemic, may increase risks for child abuse and child-witnessed IPV.

Changes in Physical Activity and Sedentary Behaviors During COVID-19: Associations with Psychological Distress Among Mothers.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic increased mothers' caregiving demands, potentially placing them at increased risk for reduced engagement in healthful behaviors and high psychological distress. PURPOSE: The purpose of this study was to describe perceived changes in moderate-vigorous physical activity (MVPA) and sedentary behaviors and the prevalence of different measures of psychological distress (depressive and anxiety symptoms, perceived stress, and positive and negative affect) among mothers. We also evaluated the associations of perceived change in MVPA and sedentary behaviors with measures of psychological distress. METHODS: We conducted a cross-sectional survey with 317 mothers living with children (0-20 years old) at home. Mothers self-reported perceived changes in MVPA and sedentary behaviors from before the pandemic to during COVID-19 stay-at-home orders and early reopening, and levels of depression and anxiety symptomatology, perceived stress, and positive and negative affect during the pandemic. RESULTS: Compared to pre-pandemic levels, 39% of mothers reported engaging less in MVPA, and 63% reported engaging in more sedentary activities. One-quarter and 31% of mothers reported moderate/severe depressive and anxiety symptoms, respectively, and 78% medium/high levels of perceived stress. Adjusted linear regression analyses revealed that reduced MVPA and increased sedentary behaviors were associated with high average scores of depressive and anxiety symptoms, perceived stress, negative affect, and low scores of positive affect. CONCLUSION: A large proportion of mothers reported being less physically active and more engaged in sedentary behaviors, which were associated with increases in psychological distress. Clinical and public health intervention efforts should consider how to improve mothers' physical and mental health as the country emerges from this crisis.

An academic-practice partnership during COVID-19 pandemic: Transitioning from a clinical to virtual fellowship.

AIMS: Discuss the needed modifications that occurred to the academic-practice oncology partnership during the COVID-19 pandemic. BACKGROUND: To meet the workforce needs of nurses who care for adults with cancer, an academic-practice partnership was created in 2016. The University of North Carolina at Chapel Hill School of Nursing, North Carolina Cancer Hospital and UNC Lineberger Comprehensive Cancer Center collaborated to provide structured clinical and didactic practice experiences for undergraduate nursing students interested in oncology nursing. With COVID-19, nursing students were not permitted to be in the clinical setting. DESIGN: Discursive paper. METHOD: An innovative and collaborative partnership created reflective and interactive activities. The majority of the learning activities were created at the revised Bloom's taxonomy level of application or higher, with some encompassing multiple levels. Students engaged in a variety of meaningful experiences requiring multiple learning processes that promoted professional development in the interpersonal and critical thinking domains. CONCLUSIONS: Despite the challenges of COVID-19, the delivery of oncology nurse fellowship was successful because of innovative virtual strategies. RELEVANCE TO CLINICAL PRACTICE: Our academic-practice partnership allowed the nursing students to develop their interpersonal and critical thinking skills without entering the clinical site. This is an approach encouraged by the authors for other schools of nursing. This manuscript is submitted as a Special Issue Discursive Article, and thus, the authors declare that an EQUATOR Checklist has not been used.