Obesity-Related Discourse on Facebook and Instagram Throughout the COVID-19 Pandemic: Comparative Longitudinal Evaluation.

BACKGROUND: COVID-19 severity is amplified among individuals with obesity, which may have influenced mainstream media coverage of the disease by both improving understanding of the condition and increasing weight-related stigma. OBJECTIVE: We aimed to measure obesity-related conversations on Facebook and Instagram around key dates during the first year of the COVID-19 pandemic. METHODS: Public Facebook and Instagram posts were extracted for 29-day windows in 2020 around January 28 (the first US COVID-19 case), March 11 (when COVID-19 was declared a global pandemic), May 19 (when obesity and COVID-19 were linked in mainstream media), and October 2 (when former US president Trump contracted COVID-19 and obesity was mentioned most frequently in the mainstream media). Trends in daily posts and corresponding interactions were evaluated using interrupted time series. The 10 most frequent obesity-related topics on each platform were also examined. RESULTS: On Facebook, there was a temporary increase in 2020 in obesity-related posts and interactions on May 19 (posts +405, 95% CI 166 to 645; interactions +294,930, 95% CI 125,986 to 463,874) and October 2 (posts +639, 95% CI 359 to 883; interactions +182,814, 95% CI 160,524 to 205,105). On Instagram, there were temporary increases in 2020 only in interactions on May 19 (+226,017, 95% CI 107,323 to 344,708) and October 2 (+156,974, 95% CI 89,757 to 224,192). Similar trends were not observed in controls. Five of the most frequent topics overlapped (COVID-19, bariatric surgery, weight loss stories, pediatric obesity, and sleep); additional topics specific to each platform included diet fads, food groups, and clickbait. CONCLUSIONS: Social media conversations surged in response to obesity-related public health news. Conversations contained both clinical and commercial content of possibly dubious accuracy. Our findings support the idea that major public health announcements may coincide with the spread of health-related content (truthful or otherwise) on social media.

The Next Infodemic: Abortion Misinformation.

The World Health Organization (WHO) defines an infodemic as the proliferation of false or misleading information that leads to confusion, mistrust in health authorities, and the rejection of public health recommendations. The devastating impacts of an infodemic on public health were felt during the COVID-19 pandemic. We are now on the precipice of another infodemic, this one regarding abortion. On June 24, 2022, the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women's Health Organization resulted in the reversal of Roe v. Wade, which had protected a woman's right to have an abortion for nearly 50 years. The reversal of Roe v. Wade has given way to an abortion infodemic that is being exacerbated by a confusing and rapidly changing legislative landscape, the proliferation of abortion disinformants on the web, lax efforts by social media companies to abate abortion misinformation, and proposed legislation that threatens to prohibit the distribution of evidence-based abortion information. The abortion infodemic threatens to worsen the detrimental effects of the Roe v. Wade reversal on maternal morbidity and mortality. It also comes with unique barriers to traditional abatement efforts. In this piece, we lay out these challenges and urgently call for a public health research agenda on the abortion infodemic to stimulate the development of evidence-based public health efforts to mitigate the impact of misinformation on the increased maternal morbidity and mortality that is expected to result from abortion restrictions, particularly among marginalized populations.

Fake news in a time of plague: Exploring individuals' online information management in the COVID-19 era

Online health information is critical during pandemics. Previous research has focused on examining antecedents or consequences of particular information behaviors (e.g., seeking, sharing), but the process by which one information behavior influences or transforms into other information behaviors remains poorly understood. Guided by theories of information behavior and the literature on online misinformation, this study proposes an interaction model of online information behaviors that theorizes relationships among online information scanning, misinformation exposure, misinformation elaboration, information sharing, and information avoidance. Conducting a two-wave representative panel survey in Hong Kong during the COVID-19 pandemic (N = 1501), we found that online information scanning at Wave 1 had a direct, positive impact on misinformation exposure and information sharing at Wave 2, while it did not have an impact on information avoidance at Wave 2. Additionally, misinformation exposure was positively related to both information sharing and information avoidance at Wave 2. Importantly, we underlined that evaluations of crisis-related misinformation are aided by misinformation elaboration, which plays a moderating role in catalyzing appropriate information behaviors. Results of this study could help scholars and practitioners propose evidence-based interventions for enhancing the public's ability to manage crisis information on the Internet in times of heightened uncertainty. © 2023 Elsevier Ltd

Awareness and use of online health information sites in the COVID-19 pandemic: a survey of postgraduate students in a Nigerian Theological Seminary

AJOL : The Internet has drastically improved access to health information for personal health care management causing a shift from traditional health information sources to online sources. Moreso the COVID-19 pandemic made many people adopt the use of online sources for health information and management. This study investigated the awareness and use of online health information sites (OHIS) by postgraduate students in the Nigerian Baptist Theological Seminary, Ogbomoso, Nigeria. A survey research design was adopted. Total enumeration was used because of the small population of respondents. Findings revealed that the students had several health information needs, but there was a low level of awareness of OHIS, as well as the use of OHIS amongst them. A high percentage did not use OHIS due to some reasons. Health information needs, awareness of OHIS, perceived usefulness of information from OHIS, perceived ease of using OHIS, and trust in OHIS are factors that influenced the use of OHIS by the students. A high percentage intended to continue using OHIS, while the non-user had the intention of using the sites in the future. The study concluded that there was a low level of awareness and use of OHIS by postgraduate students in the Nigerian Baptist Theological Seminary, Ogbomoso. In addition, health information needs, awareness of OHIS, perceived usefulness of information from OHIS, perceived ease of using OHIS, and trust in OHIS are factors that influenced the use of OHIS by the students. These factors should be leveraged to promote the use and continuous use of OHIS

Navigating Radiation Therapy During COVID-19 Using YouTube as a Source of Information.

The COVID-19 pandemic brought considerable change to the practice of radiotherapy. In the meantime, patients are increasingly turning to online resources for health information, with YouTube being one of the biggest platforms. However, little is known about what information is being disseminated to cancer patients about radiotherapy in the context of COVID-19. Therefore, this study aims to characterize and assess YouTube videos on radiotherapy during COVID-19. A YouTube search using the terms "Radiation therapy COVID-19", "Radiation therapy coronavirus", "Radiotherapy COVID-19", and "Radiotherapy coronavirus" was completed using a clear-cache web browser. The top 50 videos were collected from each search. After applying pre-determined exclusion criteria, each video was assessed for general parameters, source, and content. Two raters were used to ensure interrater reliability. One hundred five unique videos resulted from the four searches. Ninety-eight per cent were published in the last year. The median video length was 6 min and 54 s, and the median number of views was 570. Most videos were from the USA (58%). The majority of videos were published by a commercial channel (31%), non-profit organization (28%), or healthcare facility (26%). Forty-two per cent of the videos covered a topic related to radiotherapy during the pandemic. Bias was identified in 6% of videos. YouTube information on radiotherapy during COVID-19 is non-specific and can be misleading. The results of this study highlight the need for healthcare providers to proactively address patient information needs and guide them to appropriate sources of information.

Estonian Men Over 65 Are More Willing to Use Digital Technology

Digital technology offers older people an excellent opportunity to cope independently, which has become particularly apparent now in times of the COVID-19 crisis. Computers and smart devices provide additional access to a variety of online health-related information and communication with healthcare professionals, as well as digital health-related applications. Research suggests that while men are interested in digital solutions, women are more likely to seek online health information and exhibit better health behavior. The article aims to critically examine gender differences in digital technology acceptance for health purposes, online health information seeking, and COVID-19 vaccine readiness among older adults living in the small Eastern European country of Estonia. Data on the 65+ age group (65 men and 116 women) were derived from a larger survey, which contained a representative sample in terms of gender, age, and nationality and was conducted among Estonian older adults in 2020. In light of the findings of earlier research, it was surprising to learn that 65+ men in Estonia take a slightly greater interest in health information compared to their female peers, which could result from men's poorer health status. Although it was more important for women to have access to a doctor from a distance, men expressed more avid interest in various digital health gadgets and services. As it happens, they were also more willing to get vaccinated against COVID-19. Thus, this study positively dispels the myth that men are dismissive about their health and information regarding it. The results of the study imply that older people in Estonia, well-educated men in particular, are enthusiastic digital technology users for health purposes which could prove to be valuable insight to those responsible for should be taken into account when developing digital services and health campaigns.

Political ideology and differences in seeking COVID-19 information on the internet: examining the comprehensive model of information seeking

Purpose: Guided by the Comprehensive Model of Information Seeking (CMIS), this article identifies significant predictors that impact individuals seeking COVID-19 information. People with different political ideologies read contradictory information about the COVID-19 pandemic. However, how political ideology may affect COVID-19 information seeking remains unclear. This study explores the major information channels for individuals with different political ideologies to seek COVID-19 information. It further examines how political ideologies influence CMIS's effectiveness in predicting online health information-seeking. Design/methodology/approach: This study collected 394 completed survey responses from adults living in the United States after the 2020 lockdown. ANOVA analyses revealed the differences in salience, beliefs, information carrier characteristics, utilities and information-seeking actions between Liberals and Conservatives. Regression analyses discovered variables that predict Liberals' and Conservatives' online health information seeking. Findings: Results suggest that the internet is the top channel for COVID-19 information seeking. Compared to Conservatives, Liberals report more COVID-19 information-seeking actions. Liberals also express stronger salience, perceive higher trustworthiness of online COVID-19 information, are more likely to think of seeking online COVID-19 information as useful and helpful and report more substantial efficacy to mitigate the risk. Most CMIS variables predict Liberals' information seeking;however, only salience significantly predicts Conservatives' information seeking. Originality/value: This article indicates that CMIS should include political ideology to refine its prediction of information seeking. These findings offer practical implications for designing health messages, enhancing information distribution and reducing the public's uncertainty. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-08-2022-0436. © 2023, Emerald Publishing Limited.

Predictors of Cyberchondria During the COVID-19 Pandemic: Cross-sectional Study Using Supervised Machine Learning.

BACKGROUND: Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multidimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome," which is associated with health anxiety, problematic internet use, and obsessive-compulsive symptoms. Cyberchondria is not included in the International Classification of Diseases 11th Revision or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and its defining features, etiological mechanisms, and assessment continue to be debated. OBJECTIVE: This study aims to investigate changes in the severity of cyberchondria during the COVID-19 pandemic and identify the predictors of cyberchondria at this time. METHODS: Data collection started on May 4, 2020, and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the study took place, French-speaking countries in Europe (France, Switzerland, Belgium, and Luxembourg) all implemented lockdown or semilockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level, and country of residence) and information about socioeconomic circumstances during the first lockdown (eg, economic situation, housing, and employment status) and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18-77 (mean 33.29, SD 12.88) years, with females constituting the majority (416/725, 57.4%). RESULTS: The results showed that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and compulsion increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). In addition, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic. CONCLUSIONS: These findings provide evidence of the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. In addition, they are consistent with a theoretical model of cyberchondria during the COVID-19 pandemic proposed in 2020. These findings have implications for the conceptualization and future assessment of cyberchondria.

Using the Pan American Health Organization Digital Conversational Agent to Educate the Public on Alcohol Use and Health: Preliminary Analysis.

BACKGROUND: There is widespread misinformation about the effects of alcohol consumption on health, which was amplified during the COVID-19 pandemic through social media and internet channels. Chatbots and conversational agents became an important piece of the World Health Organization (WHO) response during the COVID-19 pandemic to quickly disseminate evidence-based information related to COVID-19 and tobacco to the public. The Pan American Health Organization (PAHO) seized the opportunity to develop a conversational agent to talk about alcohol-related topics and therefore complement traditional forms of health education that have been promoted in the past. OBJECTIVE: This study aimed to develop and deploy a digital conversational agent to interact with an unlimited number of users anonymously, 24 hours a day, about alcohol topics, including ways to reduce risks from drinking, that is accessible in several languages, at no cost, and through various devices. METHODS: The content development was based on the latest scientific evidence on the impacts of alcohol on health, social norms about drinking, and data from the WHO and PAHO. The agent itself was developed through a nonexclusive license agreement with a private company (Soul Machines) and included Google Digital Flow ES as the natural language processing software and Amazon Web Services for cloud services. Another company was contracted to program all the conversations, following the technical advice of PAHO staff. RESULTS: The conversational agent was named Pahola, and it was deployed on November 19, 2021, through the PAHO website after a launch event with high publicity. No identifiable data were used and all interactions were anonymous, and therefore, this was not considered research with human subjects. Pahola speaks in English, Spanish, and Portuguese and interacts anonymously with a potentially infinite number of users through various digital devices. Users were required to accept the terms and conditions to enable access to their camera and microphone to interact with Pahola. Pahola attracted good attention from the media and reached 1.6 million people, leading to 236,000 clicks on its landing page, mostly through mobile devices. Only 1532 users had a conversation after clicking to talk to Pahola. The average time users spent talking to Pahola was 5 minutes. Major dropouts were observed in different steps of the conversation flow. Some questions asked by users were not anticipated during programming and could not be answered. CONCLUSIONS: Our findings showed several limitations to using a conversational agent for alcohol education to the general public. Improvements are needed to expand the content to make it more meaningful and engaging to the public. The potential of chatbots to educate the public on alcohol-related topics seems enormous but requires a long-term investment of resources and research to be useful and reach many more people.

Understanding the Public's Attitudes Toward COVID-19 Vaccines in Nottinghamshire, United Kingdom: Qualitative Social Media Analysis.

BACKGROUND: COVID-19 vaccines remain central to the UK government's plan for tackling the COVID-19 pandemic. Average uptake of 3 doses in the United Kingdom stood at 66.7% as of March 2022; however, this rate varies across localities. Understanding the views of groups who have low vaccine uptake is crucial to guide efforts to improve vaccine uptake. OBJECTIVE: This study aims to understand the public's attitudes toward COVID-19 vaccines in Nottinghamshire, United Kingdom. METHODS: A qualitative thematic analysis of social media posts from Nottinghamshire-based profiles and data sources was conducted. A manual search strategy was used to search the Nottingham Post website and local Facebook and Twitter accounts from September 2021 to October 2021. Only comments in the public domain and in English were included in the analysis. RESULTS: A total of 3508 comments from 1238 users on COVID-19 vaccine posts by 10 different local organizations were analyzed, and 6 overarching themes were identified: trust in the vaccines, often characterized by a lack of trust in vaccine information, information sources including the media, and the government; beliefs about safety including doubts about the speed of development and approval process, the severity of side effects, and belief that the ingredients are harmful; belief that the vaccines are not effective as people can still become infected and spread the virus and that the vaccines may increase transmission through shedding; belief that the vaccines are not necessary due to low perceived risk of death and severe outcomes and use of other protective measures such as natural immunity, ventilation, testing, face coverings, and self-isolation; individual rights and freedoms to be able to choose to be vaccinated or not without judgement or discrimination; and barriers to physical access. CONCLUSIONS: The findings revealed a wide range of beliefs and attitudes toward COVID-19 vaccination. Implications for the vaccine program in Nottinghamshire include communication strategies delivered by trusted sources to address the gaps in knowledge identified while acknowledging some negatives such as side effects alongside emphasizing the benefits. These strategies should avoid perpetuating myths and avoid using scare tactics when addressing risk perceptions. Accessibility should also be considered with a review of current vaccination site locations, opening hours, and transport links. Additional research may benefit from using qualitative interviews or focus groups to further probe on the themes identified and explore the acceptability of the recommended interventions.

One Year of COVID-19 Vaccine Misinformation on Twitter: Longitudinal Study.

BACKGROUND: Vaccinations play a critical role in mitigating the impact of COVID-19 and other diseases. Past research has linked misinformation to increased hesitancy and lower vaccination rates. Gaps remain in our knowledge about the main drivers of vaccine misinformation on social media and effective ways to intervene. OBJECTIVE: Our longitudinal study had two primary objectives: (1) to investigate the patterns of prevalence and contagion of COVID-19 vaccine misinformation on Twitter in 2021, and (2) to identify the main spreaders of vaccine misinformation. Given our initial results, we further considered the likely drivers of misinformation and its spread, providing insights for potential interventions. METHODS: We collected almost 300 million English-language tweets related to COVID-19 vaccines using a list of over 80 relevant keywords over a period of 12 months. We then extracted and labeled news articles at the source level based on third-party lists of low-credibility and mainstream news sources, and measured the prevalence of different kinds of information. We also considered suspicious YouTube videos shared on Twitter. We focused our analysis of vaccine misinformation spreaders on verified and automated Twitter accounts. RESULTS: Our findings showed a relatively low prevalence of low-credibility information compared to the entirety of mainstream news. However, the most popular low-credibility sources had reshare volumes comparable to those of many mainstream sources, and had larger volumes than those of authoritative sources such as the US Centers for Disease Control and Prevention and the World Health Organization. Throughout the year, we observed an increasing trend in the prevalence of low-credibility news about vaccines. We also observed a considerable amount of suspicious YouTube videos shared on Twitter. Tweets by a small group of approximately 800 "superspreaders" verified by Twitter accounted for approximately 35% of all reshares of misinformation on an average day, with the top superspreader (@RobertKennedyJr) responsible for over 13% of retweets. Finally, low-credibility news and suspicious YouTube videos were more likely to be shared by automated accounts. CONCLUSIONS: The wide spread of misinformation around COVID-19 vaccines on Twitter during 2021 shows that there was an audience for this type of content. Our findings are also consistent with the hypothesis that superspreaders are driven by financial incentives that allow them to profit from health misinformation. Despite high-profile cases of deplatformed misinformation superspreaders, our results show that in 2021, a few individuals still played an outsized role in the spread of low-credibility vaccine content. As a result, social media moderation efforts would be better served by focusing on reducing the online visibility of repeat spreaders of harmful content, especially during public health crises.

Digital Health Literacy and Information-Seeking in the Era of COVID-19: Gender Differences Emerged from a Florentine University Experience.

Gender appears to be a strong predictor of online health information-seeking behaviour (OHISB), which is related to Digital Health Literacy (DHL). Gender differences in OHISB have been studied in different countries with different results, but no studies have investigated gender-specific OHISB among University students during the COVID-19 pandemic. We sought to investigate any gender differences in OHISB in the period between the first and second waves of the pandemic in Italian university students. A questionnaire developed by the global COVID-HL network, including existing and adapted validated scales and self-developed scales, was administered to 2996 University students in Florence. Gender differences were tested using the χ2 test or the Mann-Whitney U test. Male students reported a higher score in DHL than females (p < 0.001). However, female students seek COVID-19 information more often on different sources (for themselves and other people), on various topics, consider various aspects of information quality to be "very important'' (p < 0.05) and are more likely to be "often dissatisfied'' or "partly satisfied'' with information (p < 0.001). Our study confirmed gender as an important dimension to explain students' OHISB differences, which could help institutions promote gender-specific education programmes and provide gender-oriented health information.

COVID-19 and Dr. Google: Parents' changing experience using online health information about their children's health during the pandemic.

AIMS: To identify how the COVID-19 pandemic influences parents' use of the internet, including social media, when seeking health-related information about the pandemic relevant to their children. METHODS: This study employed semi-structured interviews to explore the factors affecting parents of young children when information-seeking online about their children's health related to the COVID-19 pandemic. Parents of children with and without chronic health conditions were interviewed in July and August 2020. Interviews were audio-recorded and transcribed verbatim, then analysed using theoretical thematic analysis, based on Social Cognitive Theory. RESULTS: Through interviews with 13 parents, we identified a myriad of factors that affected parents' internet searching. The decision to access online health information and the regulation of its usage was multifaceted and relied upon the interactions between environmental triggers and parents' information needs, personal attitudes, and circumstances. Overall, parents felt supported by online health information during the COVID-19 pandemic, and the majority were confident in their ability to navigate the plethora of online health information. However, parents of children with chronic conditions had unmet information needs in relation to COVID-19 and their children's condition. CONCLUSIONS: Understanding parents' attitudes and behaviours when seeking online health information that is relevant to their children during a global pandemic can inform the optimisation of online health content delivery to parents.

Sustained Reductions in Online Search Interest for Communicable Eye and Other Conditions During the COVID-19 Pandemic: Infodemiology Study.

Background: In a prior study at the start of the pandemic, we reported reduced numbers of Google searches for the term "conjunctivitis" in the United States in March and April 2020 compared with prior years. As one explanation, we conjectured that reduced information-seeking may have resulted from social distancing reducing contagious conjunctivitis cases. Here, after 1 year of continued implementation of social distancing, we asked if there have been persistent reductions in searches for "conjunctivitis," and similarly for other communicable disease terms, compared to control terms. Objective: The aim of this study was to determine if reduction in searches in the United States for terms related to conjunctivitis and other common communicable diseases occurred in the spring-winter season of the COVID-19 pandemic, and to compare this outcome to searches for terms representing noncommunicable conditions, COVID-19, and to seasonality. Methods: Weekly relative search frequency volume data from Google Trends for 68 search terms in English for the United States were obtained for the weeks of March 2011 through February 2021. Terms were classified a priori as 16 terms related to COVID-19, 29 terms representing communicable conditions, and 23 terms representing control noncommunicable conditions. To reduce bias, all analyses were performed while masked to term names, classifications, and locations. To test for the significance of changes during the pandemic, we detrended and compared postpandemic values to those expected based on prepandemic trends, per season, computing one- and two-sided P values. We then compared these P values between term groups using Wilcoxon rank-sum and Fisher exact tests to assess if non-COVID-19 terms representing communicable diseases were more likely to show significant reductions in searches in 2020-2021 than terms not representing such diseases. We also assessed any relationship between a term's seasonality and a reduced search trend for the term in 2020-2021 seasons. P values were subjected to false discovery rate correction prior to reporting. Data were then unmasked. Results: Terms representing conjunctivitis and other communicable conditions showed a sustained reduced search trend in the first 4 seasons of the 2020-2021 COVID-19 pandemic compared to prior years. In comparison, the search for noncommunicable condition terms was significantly less reduced (Wilcoxon and Fisher exact tests, P<.001; summer, autumn, winter). A significant correlation was also found between reduced search for a term in 2020-2021 and seasonality of that term (Theil-Sen, P<.001; summer, autumn, winter). Searches for COVID-19-related conditions were significantly elevated compared to those in prior years, and searches for influenza-related terms were significantly lower than those for prior years in winter 2020-2021 (P<.001). Conclusions: We demonstrate the low-cost and unbiased use of online search data to study how a wide range of conditions may be affected by large-scale interventions or events such as social distancing during the COVID-19 pandemic. Our findings support emerging clinical evidence implicating social distancing and the COVID-19 pandemic in the reduction of communicable disease and on ocular conditions.

Dr. Google: Physicians-The Web-Patients Triangle: Digital Skills and Attitudes towards e-Health Solutions among Physicians in South Eastern Poland-A Cross-Sectional Study in a Pre-COVID-19 Era.

The investment in digital e-health services is a priority direction in the development of global healthcare systems. While people are increasingly using the Web for health information, it is not entirely clear what physicians' attitudes are towards digital transformation, as well as the acceptance of new technologies in healthcare. The aim of this cross-sectional survey study was to investigate physicians' self-digital skills and their opinions on obtaining online health knowledge by patients, as well as the recognition of physicians' attitudes towards e-health solutions. Principal component analysis (PCA) was performed to emerge the variables from self-designed questionnaire and cross-sectional analysis, comparing descriptive statistics and correlations for dependent variables using the one-way ANOVA (F-test). A total of 307 physicians participated in the study, reported as using the internet mainly several times a day (66.8%). Most participants (70.4%) were familiar with new technologies and rated their e-health literacy high, although 84.0% reported the need for additional training in this field and reported a need to introduce a larger number of subjects shaping digital skills (75.9%). 53.4% of physicians perceived Internet-sourced information as sometimes reliable and, in general, assessed the effects of its use by their patients negatively (41.7%). Digital skills increased significantly with frequency of internet use (F = 13.167; p = 0.0001) and decreased with physicians' age and the need for training. Those who claimed that patients often experienced health benefits from online health showed higher digital skills (-1.06). Physicians most often recommended their patients to obtain laboratory test results online (32.2%) and to arrange medical appointments via the Internet (27.0%). Along with the deterioration of physicians' digital skills, the recommendation of e-health solutions decreased (r = 0.413) and lowered the assessment of e-health solutions for the patient (r = 0.449). Physicians perceive digitization as a sign of the times and frequently use its tools in daily practice. The evaluation of Dr. Google's phenomenon and online health is directly related to their own e-health literacy skills, but there is still a need for practical training to deal with the digital revolution.

Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study.

BACKGROUND: The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. OBJECTIVE: This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. METHODS: In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19-specific information. RESULTS: Among all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. CONCLUSIONS: Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.

Associations Between the Perceived Severity of the COVID-19 Pandemic, Cyberchondria, Depression, Anxiety, Stress, and Lockdown Experience: Cross-sectional Survey Study.

BACKGROUND: The outbreak of the COVID-19 pandemic has caused great panic among the public, with many people suffering from adverse stress reactions. To control the spread of the pandemic, governments in many countries have imposed lockdown policies. In this unique pandemic context, people can obtain information about pandemic dynamics on the internet. However, searching for health-related information on the internet frequently increases the possibility of individuals being troubled by the information that they find, and consequently, experiencing symptoms of cyberchondria. OBJECTIVE: We aimed to examine the relationships between people's perceived severity of the COVID-19 pandemic and their depression, anxiety, and stress to explore the role of cyberchondria, which, in these relationship mechanisms, is closely related to using the internet. In addition, we also examined the moderating role of lockdown experiences. METHODS: In February 2020, a total of 486 participants were recruited through a web-based platform from areas in China with a large number of infections. We used questionnaires to measure participants' perceived severity of the COVID-19 pandemic, to measure the severity of their cyberchondria, depression, anxiety, and stress symptoms, and to assess their lockdown experiences. Confirmatory factor analysis, exploratory factor analysis, common method bias, descriptive statistical analysis, and correlation analysis were performed, and moderated mediation models were examined. RESULTS: There was a positive association between perceived severity of the COVID-19 pandemic and depression (ß=0.36, t=8.51, P<.001), anxiety (ß=0.41, t=9.84, P<.001), and stress (ß=0.46, t=11.45, P<.001), which were mediated by cyberchondria (ß=0.36, t=8.59, P<.001). The direct effects of perceived severity of the COVID-19 pandemic on anxiety (ß=0.07, t=2.01, P=.045) and stress (ß=0.09, t=2.75, P=.006) and the indirect effects of cyberchondria on depression (ß=0.10, t=2.59, P=.009) and anxiety (ß=0.10, t=2.50, P=.01) were moderated by lockdown experience. CONCLUSIONS: The higher the perceived severity of the COVID-19 pandemic, the more serious individuals' symptoms of depression, anxiety, and stress. In addition, the associations were partially mediated by cyberchondria. Individuals with higher perceived severity of the COVID-19 pandemic were more likely to develop cyberchondria, which aggravated individuals' depression, anxiety, and stress symptoms. Negative lockdown experiences exacerbated the COVID-19 pandemic's impact on mental health.

Social Media Use and Hypertension Knowledge among Undergraduate Students during the COVID-19 Pandemic in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

Introduction: : Malaysian hypertension prevalence is high at 30% and is the highest risk factor for mortality. Good hypertension knowledge suggests a favourable outcome. Online sources are a popular method of obtaining information especially in young adults and during the pandemic. Our objective is to determine health information seeking online, use of social media, and hypertension knowledge among undergraduate students. Methods: This is a cross-sectional study conducted in the Faculty of Medicine and Health Sciences (FHMS), Universiti Putra Malaysia (UPM). Random sampling was done. An online questionnaire with four sections: (1) socio-demographic data;(2) use of social media;(3) health information sought online;and (4) hypertension knowledge was used . Data were analysed using the SPSS version 25 using Independent T tests and one-way ANOVA to identify factors associated with hypertension knowledge. Results: Mean (SD) age of 286 respondents was 21(1.2) years. Most respondents were female, 207(73.1%), Malays, 177(61.9%) and taking the Medicine course 127(44.4) with a mean of 9.50(4.50) hours of internet usage daily. Many respondents 196(68.5%) looked for information on hypertension online. The mean score for hypertension knowledge was 8.32(1.46);classified as good knowledge. Hypertension knowledge was significantly associated with race (p<0.001), type of course (p<0.001), year of study (p<0.001) and type of health information searched online (p=0.010). Conclusion: We found significant better knowledge in Indians compared to Malays, medical students compared to biomedical sciences and occupational health, students in year 5 compared to years 1&2. Participants that searched on hypertension online had better knowledge on hypertension. © 2022 UPM Press. All rights reserved.

Reinterpretation of Health Information in the Context of an Emerging Infectious Disease: A Digital Focus Group Study.

BACKGROUND: Misinformation related to the COVID-19 pandemic has accelerated global public concern and panic. The glut of information, or "infodemic," has caused concern for authorities due to its negative impacts on COVID-19 prevention and control, spurring calls for a greater scholarly focus on health literacy during the pandemic. Nevertheless, few studies have sought to qualitatively examine how individuals interpreted and assimilated health information at the initial wave of COVID-19 restrictions. OBJECTIVE: We developed this qualitative study adopting chat-based focus group discussions to investigate how individuals interpreted COVID-19 health information during the first wave of COVID-19 restrictions. METHODS: We conducted a qualitative study in Singapore to investigate how individuals perceive and interpret information that they receive on COVID-19. Data were generated through online focus group discussions conducted on the mobile messaging smartphone app WhatsApp. From March 28 to April 13, 2020, we held eight WhatsApp-based focus groups (N=60) with participants stratified by age groups, namely 21-30 years, 31-40 years, 41-50 years, and 51 years and above. Data were thematically analyzed. RESULTS: A total of four types of COVID-19 health information were generated from the thematic analysis, labeled as formal health information, informal health information, suspicious health information, and fake health information, respectively. How participants interpreted these categories of information depended largely on the perceived trustworthiness of the information source as well as the perceived veracity of information. Both factors were instrumental in determining individuals' perceptions, and their subsequent treatment and assimilation of COVID-19-related information. CONCLUSIONS: Both perceived trustworthiness of the information source and perceived veracity of information were instrumental concepts in determining one's perception, and thus subsequent treatment and assimilation of such information for one's knowledge of COVID-19 or the onward propagation to their social networks. These findings have implications for how policymakers and health authorities communicate with the public and deal with fake health information in the context of COVID-19.

Online health information seeking and digital health literacy among information and learning resources undergraduate students.

Background: During the COVID-19 pandemic, students have trouble coping with the available health information regarding the coronavirus in their daily lives because of misinformation. Objectives: The aim of this study was to evaluate online health information seeking and digital health literacy among information and learning resources undergraduate students at Taibah University during the COVID-19 pandemic. Methods: To investigate the primary goal, this study used a simultaneous exploratory mixed methods design. Seventeen students participated in phone interviews, and 306 were invited to complete an online survey. Analysis: The collected data was analyzed using both quantitative (SPSS) and qualitative (NVivo 10) methods. Results: Search engines, social media, and YouTube were most often used by the respondents as sources to search for COVID-19-related information. COVID-19 symptoms, restrictions, and the current spread of COVID-19 were the most searched topics by the respondents. Significant and relevant differences emerged for the digital health literacy subscales "information search" and "adding self-generated content". However, there were no significant differences in the digital health literacy subscale "determining relevance". Conclusion: Using the internet to provide health information tailored to the needs and interests of students to seek health information online and thereby improve their health literacy.