The evaluation of telemedicine-online health services during Covid-19 in Turkey private hospitals: Thematic analysis

Aim: With the Covid-19 outbreak, it has been observed that people wanted to receive healthcare services remotely. In other words, people wanted to reach healthcare services or healthcare professionals from their homes without going to the hospital. Thus, this study aimed to determine how telemedicine-online health services of private hospitals are handled on websites and social media channels. Material(s) and Method(s): Data was collected by conducting qualitative content analysis to the websites and corporate social media of hospitals in Istanbul, the city where the most private hospitals in Turkey are located. Overall, 608 data from 76 hospitals were analysed using the thematic analysis method. Result(s): When the analysis of the information was received a total of 8 themes emerged. These were divided into thematic codes as the telemedicine-online health service status, including the number of hospital beds, the content of written, visuals etc. posts, features of the branches of the application and details of other online health services. Discussion(s): The use of telemedicine-online health services in private hospitals is found to be at the initial stage and written and visual posts are insufficient. The information collected can help determine the current situation and contribute to private hospitals when determining new strategies.Copyright © 2021, Derman Medical Publishing. All rights reserved.

Factors influencing loyalty to online health consultation platform: a cross-strait cultural perspective.

BACKGROUND: The geographical, cultural, and linguistic proximity between Taiwan and Mainland China has facilitated rapid growth of cross-strait interactions. Both countries have developed online health consultation platforms on the Internet for the public to access healthcare related information. This study examines factors that influence loyalty to a specific online health consultation platform (OHCP) from a cross-strait perspective. METHODS: Based on the Expectation Confirmation Theory and the combined Trust, Perceived Health Risks and Culture, we examine factors that influence loyalty to OHCPs among cross-strait users by investigating the roles of trust, perceived health risks, and culture. Data was collected through a questionnaire survey. RESULTS: The research models used provide a high-power explanation of loyalty to OHCPs. Results generally align with those of previous studies, with the exception of the relationships between Perceived Health Risks and Perceived Usefulness, Perceived Usefulness and Loyalty, Confirmation and Satisfaction, and Trust and Loyalty. In other words, culture may have moderated these relationships. CONCLUSIONS: Findings can help promote OHCPs among cross-strait users to make things easier for patients, and further reduce the load on the emergency department, especially in view of the still ongoing issues related to global outbreak of Coronavirus disease by facilitating early detection of potential cases.

Switching from offline to online health consultation in the post-pandemic era: the role of perceived pandemic risk.

Introduction: Due to its effectiveness and various benefits, the use of online health consultation (OHC) has dramatically increased in recent years, especially since the outbreak of the COVID-19 pandemic. However, underlying mechanism whereby the pandemic impacted OHC usage is still unclear. Methods: Via an online survey (N=318), the present paper measures the users' perceptions towards both offline and online services, their intention to switch to OHC, and the perceived pandemic risks. The relationships among these factors are conceptualized by the push-pull-mooring framework, and tested via structural equation modelling. Results: Dissatisfaction with offline service (process inefficiency and consultation anxiety), the attractiveness of OHC (perceived benefits and perceived ease of use), and users' behavioral inertia (switching cost and habit) jointly influence the intention to switching to OHC. The significant role of the perceived pandemic risk of going to medical facilities is particularly addressed. On the one hand, the perceived pandemic risk is found with an indirect impact on the switching intention by enlarging the dissatisfaction with offline service and the attractiveness of OHC. On the other hand, a high perceived pandemic risk induces more actual switching behavior and also amplifies the transition from switching intention to behavior. Discussion: The study provides novel insights into the understanding of OHC usage in the post-pandemic era, and also informs medical facilities, OHC platforms, and policymakers on managing and balancing the online and offline healthcare provision.

How COVID-19 Affects the Willingness of the Elderly to Continue to Use the Online Health Community: A Longitudinal Survey

In response to the COVID-19 outbreak, the governments of different countries adopted restrictions, such as locking down cities and restricting travel and social contact. Online health communities (OHCs) with specialized physicians have become an important way for the elderly to access health information and social support, which has expanded their use since the outbreak. This paper examines the factors influencing elderly people's behavior in terms of the continuous use of OHCs from a social support perspective to understand the impact of public health emergencies. Research collected data from March to April 2019, February 2020, and August 2021 in China. A total of 189 samples were collected and analyzed by using SmartPLS. The results show that (1) social support to the elderly during different stages has different influences on their sense of community and (2) the influence of the sense of community on the intention to continuously use OHCs also seems to change over time. The results of this study provide important implications for research and practice related to both OHCs and COVID-19. © 2022 IGI Global. All rights reserved.

Factors Affecting Users' Continuous Usage in Online Health Communities: An Integrated Framework of SCT and TPB.

BACKGROUND: Online health communities (OHCs) provide a new channel for users to obtain more health-related information and support, playing an important role in alleviating hospital congestion and uneven medical resource distribution, especially during the COVID-19 pandemic in China. An in-depth study of users' continuous usage is of great value for the long-term development of OHCs. OBJECTIVE: The purpose of this study is to explore the factors that influence users' continuous usage in online health communities based on the theory of planned behavior (TPB) and social cognitive theory (SCT). METHODS: Data from 480 users with experience in online health communities were collected through a questionnaire survey, and structural equations were applied to verify the model hypotheses empirically. RESULTS: Self-efficacy and controllability have significant effects on users' continuous intention; attitude has a significant relationship with continuous intention; social norms have a positive effect on continuous intention. Moreover, the relationship between continuous intention and behavior is positive. Self-efficacy and outcome expectations have significant positive associations with continuous usage. Finally, system quality, information quality, and social interaction ties have significant and positive relationships to continuous usage. CONCLUSION: To improve the level of user's continuous usage, online health service providers can improve the quality of the community by organizing the website's page layout, navigation menus, and site elements to ensure users quickly search and find what they want meanwhile try to change people's cognition gradually, in addition, decision and policymakers should provide more favorable policies to stimulate and help provider in building and managing strategic plans for sustaining a thriving online community. A supportive climate in society through public service advertisements and others for the sake of OHCs is necessary. LIMITATIONS: (1) This study collected data through a cross-sectional survey. Thus, it lacked the process of capturing the changes in participants' attitudes toward all variables. (2) The environmental factors in SCT theory need to be more comprehensive, containing online factors without offline factors. (3) The dates were obtained from China, which neglects the different cultural content.

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.

African American Women's Willingness to Participate in Online Health Communities During COVID-19.

Introduction: The use of online health communities (OHCs) for health information, disease self-management, and social support increased during the COVID-19 pandemic. However, there are limited data on the willingness of African American women (AAW) to participate in OHCs. Materials and Methods: A sample of 985 AAW completed an online survey. Multinomial logistic regression examined associations between three age groups (18-29, 30-50, and 51+ years) and 10 motivators and 10 barriers to participating in OHCs. Women 51+ years were the referent group. Results: Women 51+ years were more likely to have been diagnosed with obesity and hypertension than the other groups (p < 0.01), but less likely to be diagnosed with a mental health condition than the other groups (p < 0.01). The top 2 motivators were to learn about a disease/condition (70%) and to prevent a disease/condition (64%). There were no significant differences with these variables. However, compared with women 18-29 years of age, women 51+ years were more likely to be motivated to manage an illness (p < 0.001), and more likely than the other groups to be motivated to support others (p = 0.011). The top 2 barriers were being too busy (53%) and privacy concerns (45%). Compared with women in the two other groups, women 51+ years were more concerned about privacy (p < 0.001). Discussion: AAW expressed a willingness to participate in OHCs. Willingness to participate in OHCs will vary by the topic and disease/condition and the age group. Conclusions: Opportunities exist to recruit AAW in age-specific OHCs.

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

Investigation of the Readability and Reliability of Online Health Information for Cancer Patients During the Coronavirus Pandemic.

For cancer patients undergoing treatment who may be at higher risk of COVID-19, access to high-quality online health information (OHI) may be of particular importance amidst a plethora of harmful medical misinformation online. Therefore, we assessed the readability and quality of OHI available for various cancer types and treatment modalities. Search phrases included "cancer radiation COVID," "cancer surgery COVID," "cancer chemotherapy COVID," and "cancer type COVID," for the fourteen most common cancer types (e.g., "prostate cancer COVID" and "breast cancer COVID"), yielding a total of 17 search phrases. The first 20 sources were recorded and analyzed for each keyword, yielding a total of 340 unique sources. For each of these sources, the approximate grade level required to comprehend the text was calculated as a mean of five validated readability scores; subsequently, for the first ten results of each search, the DISCERN tool was manually used to assess quality. Search terms were translated into Spanish and French, and a quality assessment using the Health on the Net Code (HONcode) accreditation was conducted. The median grade level readability for all sources was 13 (IQR 11-14). Median DISCERN scores for the 170 sources assessed were 55 out of 75, suggesting good quality. OHI with quality scores below the median DISCERN score had a median readability of 12.5 (IQR 11-14) grade reading level vs 14 (IQR 12-17) for those above the median DISCERN score (T-test P < 0.0001). Percentages of HONcode-accredited websites were 34.9%, 39.9%, and 38.6% for English, Spanish, and French OHI, respectively. We conclude that efforts are needed to make high-quality OHI available at the appropriate reading level for patients with cancer; such efforts may contribute to the alleviation of disparities in access to healthcare information.

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.

How COVID-19 Affects the Willingness of the Elderly to Continue to Use the Online Health Community: A Longitudinal Survey

In response to the COVID-19 outbreak, the governments of different countries adopted, such as locking down cities and restricting travel and social contact. Online health communities (OHCs) with specialized physicians have become an important way for the elderly to access health information and social support, which has expanded their use since the outbreak. This paper examines the factors influencing elderly people's behavior in terms of the continuous use of OHCs from a social support perspective, to understand the impact of public health emergencies. Research collected data from March to April 2019, February 2020, and August 2021, in China. A total of 189 samples were collected and analyzed by using SmartPLS. The results show that (1) social support to the elderly during different stages has different influences on their sense of community and (2) the influence of the sense of community on the intention to continuously use OHCs also seems to change over time. The results of this study provide important implications for research and practice related to both OHCs and COVID-19.

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.

Exploring help-seeking behavior in online health communities among women with domestic violence experiences

Background: Domestic violence (DV) is one of the most pressing women's health concerns globally. Previous literature shows that women tend to seek help from informal sources (i.e., close friends and family) rather than formal sources (i.e., legal and police). Owing to the increased time spent at home and worsened social isolation during the COVID-19 pandemic, more women experiencing DV visited online health communities (OHCs) to seek help due to their anonymity and timely responses. However, OHCs may circulate unverified risky, and unhealthy information to users. Despite the surge of literature examining information discussed in the DV population, it is still unclear what types of help women sought and received the most from OHCs. Without such knowledge, we cannot evaluate the usefulness of OHCs for women who would like to seek help in OHCs after a traumatic DV experience.Purpose: The aims of this study were to 1) describe the types of help sought by the women with DV experiences in OHCs, 2) describe the type and pattern (i.e., communication style) of the advice given in the OHC to women with DV experiences and 3) explore whether the needs of women with DV experiences were matched with the help they received in OHCs. Methods: This is an exploratory, descriptive study to explore help-seeking behaviors by women experiencing DV on the subreddit community r/domesticviolence from November 14, 2020, through November 14, 2021. For our analysis, we included posts by adult women (i.e., aged 18 or above) experiencing DV who seek advice on DV relationships or dealing with DV-related issues. We excluded posts from non-abused women, women victims under 18, non-English posts, good news announcements, gratitude posts without any advice-seeking, and posts related to advertisements. Two nursing students used the codebook developed and verified by a domain expert. Aims 1 & 2 used manual annotation and thematic analysis and Aim 3 used computation text mining tool (i.e., Linguistic Inquiry Word Count) and non-parametric statistical analysis (i.e., t-test or Mann-Whitney U). Results: Among 1,996 postings crawled, 250 postings were included after screening for women with DV experience. 68.8% sought information support, and 36% sought emotional support. DV (n = 43, 25%) and legal (n = 21, 12.2%) knowledge were the most frequent types of information help being sought. Based on initial postings, five themes emerged. 97.2% of the postings received information support, while 87.6% received emotional support. DV knowledge (n=414, 26.4%), DV shelter (n=242, 15.4%), and legal knowledge (n=190, 12.1%) were the most frequent types of information help received in OHC, while 68.6 % of postings received encouragement as emotional support. 29.6% offered networking help, and 78% offered experience sharing. Based on the comments, seven themes emerged. 80% of postings matched with the type of help requested, while 17 linguistic or postings features were found to be significantly different between the two groups (i.e., matched help and unmatched help). Conclusions: OHC is a resourceful platform for help-seeking among women with DV experience. This study can guide the development of future algorithms to detect help-seeking behavior within OHCs effectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

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.

How information processing and risk/benefit perception affect COVID-19 vaccination intention of users in online health communities.

Objective: To investigate the relationship among information processing, risk/benefit perception and the COVID-19 vaccination intention of OHCs users with the heuristic-systematic model (HSM). Methods: This study conducted a cross-sectional questionnaire via an online survey among Chinese adults. A structural equation model (SEM) was used to examine the research hypotheses. Results: Systematic information processing positively influenced benefit perception, and heuristic information processing positively influenced risk perception. Benefit perception had a significant positive effect on users' vaccination intention. Risk perception had a negative impact on vaccination intention. Findings revealed that differences in information processing methods affect users' perceptions of risk and benefit, which decide their vaccination intention. Conclusion: Online health communities can provide more systematic cues and users should process information systematically to increase their perceived benefits, consequently increase their willingness to receive COVID-19 vaccine.

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.