Consumer Informatics and COVID-19 Pandemics: Challenges and Opportunities for Research.

OBJECTIVE: To summarise the state of the art during the year 2020 in consumer health informatics and education, with a special emphasis on "Managing Pandemics with Health Informatics - Successes and Challenges". METHODS: We conducted a systematic search of articles published in PubMed using a predefined set of queries, which identified 147 potential articles for review. These articles were screened according to topic relevance and 15 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Three papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for managing pandemics in the year 2020. RESULTS: Bibliometrics analysis conducted on words found in abstracts of the candidate papers revealed 4 clusters of articles, where the clustering outcomes explained 77.04% of the dispersion. The first cluster composed of articles related to the use of mobile apps for video consultation and telehealth during the pandemic. The second revealed studies reporting the lived experience of healthcare workers and patients during COVID-19. The third focused on ways people used the internet to seek for health information during the pandemic and the dissemination of fake news. The last cluster composed of articles reporting the use of social listening methods (e.g., via tweet hashtags) to explore the spread of the virus around the world. CONCLUSIONS: The pandemic outbreak of the novel coronavirus disease (COVID-19) constitutes a grave risk to the global community and sparks a significant increase in public interest and media coverage, especially on social media. Consumers are facing a new set of challenges that were not considered before COVID-19, often finding themselves in a world that is constantly changing-blended with facts and fake information-and unable to decide what to do next. Despite most people understanding the good will behind public health policies, one must not forget it is individuals we are supporting and that their personal circumstances may affect how they perceive and comply with these policies. Consumers more than ever need help to make sense of the uncertainty and their situation and we need to help them navigate the best option in a world that is constantly evolving.

Implementation methodology from a social systems informatics and engineering perspective applied to a parenting training program.

OBJECTIVE: For implementation of an evidence-based program to be effective, efficient, and equitable across diverse populations, we propose that researchers adopt a systems approach that is often absent in efficacy studies. To this end, we describe how a computer-based monitoring system can support the delivery of the New Beginnings Program (NBP), a parent-focused evidence-based prevention program for divorcing parents. METHOD: We present NBP from a novel systems approach that incorporates social system informatics and engineering, both necessary when utilizing feedback loops, ubiquitous in implementation research and practice. Examples of two methodological challenges are presented: how to monitor implementation, and how to provide feedback by evaluating system-level changes due to implementation. RESULTS: We introduce and relate systems concepts to these two methodologic issues that are at the center of implementation methods. We explore how these system-level feedback loops address effectiveness, efficiency, and equity principles. These key principles are provided for designing an automated, low-burden, low-intrusive measurement system to aid fidelity monitoring and feedback that can be used in practice. DISCUSSION: As the COVID-19 pandemic now demands fewer face-to-face delivery systems, their replacement with more virtual systems for parent training interventions requires constructing new implementation measurement systems based on social system informatics approaches. These approaches include the automatic monitoring of quality and fidelity in parent training interventions. Finally, we present parallels of producing generalizable and local knowledge bridging systems science and engineering method. This comparison improves our understanding of system-level changes, facilitates a program's implementation, and produces knowledge for the field. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Role of Participatory Health Informatics in Detecting and Managing Pandemics: Literature Review.

OBJECTIVES: Using participatory health informatics (PHI) to detect disease outbreaks or learn about pandemics has gained interest in recent years. However, the role of PHI in understanding and managing pandemics, citizens' role in this context, and which methods are relevant for collecting and processing data are still unclear, as is which types of data are relevant. This paper aims to clarify these issues and explore the role of PHI in managing and detecting pandemics. METHODS: Through a literature review we identified studies that explore the role of PHI in detecting and managing pandemics. Studies from five databases were screened: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), IEEE Xplore, ACM (Association for Computing Machinery) Digital Library, and Cochrane Library. Data from studies fulfilling the eligibility criteria were extracted and synthesized narratively. RESULTS: Out of 417 citations retrieved, 53 studies were included in this review. Most research focused on influenza-like illnesses or COVID-19 with at least three papers on other epidemics (Ebola, Zika or measles). The geographic scope ranged from global to concentrating on specific countries. Multiple processing and analysis methods were reported, although often missing relevant information. The majority of outcomes are reported for two application areas: crisis communication and detection of disease outbreaks. CONCLUSIONS: For most diseases, the small number of studies prevented reaching firm conclusions about the utility of PHI in detecting and monitoring these disease outbreaks. For others, e.g., COVID-19, social media and online search patterns corresponded to disease patterns, and detected disease outbreak earlier than conventional public health methods, thereby suggesting that PHI can contribute to disease and pandemic monitoring.

Using Narrative Evidence to Convey Health Information on Social Media: The Case of COVID-19.

During disease outbreaks or pandemics, policy makers must convey information to the public for informative purposes (eg, morbidity or mortality rates). They must also motivate members of the public to cooperate with the guidelines, specifically by changing their usual behavior. Policy makers have traditionally adopted a didactic and formalistic stance by conveying dry, statistics-based health information to the public. They have not yet considered the alternative of providing health information in the form of narrative evidence, using stories that address both cognitive and emotional aspects. The aim of this viewpoint paper is to introduce policy makers to the advantages of using narrative evidence to provide health information during a disease outbreak or pandemic such as COVID-19. Throughout human history, authorities have tended to employ apocalyptic narratives during disease outbreaks or pandemics. This viewpoint paper proposes an alternative coping narrative that includes the following components: segmentation; barrier reduction; role models; empathy and support; strengthening self-efficacy, community efficacy, and coping tools; preventing stigmatization of at-risk populations; and communicating uncertainty. It also discusses five conditions for using narrative evidence to produce an effective communication campaign on social media: (1) identifying narratives that reveal the needs, personal experiences, and questions of different subgroups to tailor messaging to produce targeted behavioral change; (2) providing separate and distinct treatment of each information unit or theory that arises on social networks; (3) identifying positive deviants who found creative solutions for stress during the COVID-19 crisis not found by other members of the community; (4) creating different stories of coping; and (5) maintaining a dialogue with population subgroups (eg, skeptical and hesitant groups). The paper concludes by proposing criteria for evaluating the effectiveness of a narrative.

An interactive online dashboard for tracking COVID-19 in U.S. counties, cities, and states in real time.

OBJECTIVE: The study sought to create an online resource that informs the public of coronavirus disease 2019 (COVID-19) outbreaks in their area. MATERIALS AND METHODS: This R Shiny application aggregates data from multiple resources that track COVID-19 and visualizes them through an interactive, online dashboard. RESULTS: The Web resource, called the COVID-19 Watcher, can be accessed online (https://covid19watcher.research.cchmc.org/). It displays COVID-19 data from every county and 188 metropolitan areas in the United States. Features include rankings of the worst-affected areas and auto-generating plots that depict temporal changes in testing capacity, cases, and deaths. DISCUSSION: The Centers for Disease Control and Prevention does not publish COVID-19 data for local municipalities, so it is critical that academic resources fill this void so the public can stay informed. The data used have limitations and likely underestimate the scale of the outbreak. CONCLUSIONS: The COVID-19 Watcher can provide the public with real-time updates of outbreaks in their area.

Rapid development of telehealth capabilities within pediatric patient portal infrastructure for COVID-19 care: barriers, solutions, results.

The COVID-19 national emergency has led to surging care demand and the need for unprecedented telehealth expansion. Rapid telehealth expansion can be especially complex for pediatric patients. From the experience of a large academic medical center, this report describes a pathway for efficiently increasing capacity of remote pediatric enrollment for telehealth while fulfilling privacy, security, and convenience concerns. The design and implementation of the process took 2 days. Five process requirements were identified: efficient enrollment, remote ability to establish parentage, minimal additional work for application processing, compliance with guidelines for adolescent autonomy, and compliance with institutional privacy and security policies. Weekly enrollment subsequently increased 10-fold for children (age 0-12 years) and 1.2-fold for adolescents (age 13-17 years). Weekly telehealth visits increased 200-fold for children and 90-fold for adolescents. The obstacles and solutions presented in this report can provide guidance to health systems for similar challenges during the COVID-19 response and future disasters.

Leveraging conversational technology to answer common COVID-19 questions.

The rapidly evolving science about the Coronavirus Disease 2019 (COVID-19) pandemic created unprecedented health information needs and dramatic changes in policies globally. We describe a platform, Watson Assistant (WA), which has been used to develop conversational agents to deliver COVID-19 related information. We characterized the diverse use cases and implementations during the early pandemic and measured adoption through a number of users, messages sent, and conversational turns (ie, pairs of interactions between users and agents). Thirty-seven institutions in 9 countries deployed COVID-19 conversational agents with WA between March 30 and August 10, 2020, including 24 governmental agencies, 7 employers, 5 provider organizations, and 1 health plan. Over 6.8 million messages were delivered through the platform. The mean number of conversational turns per session ranged between 1.9 and 3.5. Our experience demonstrates that conversational technologies can be rapidly deployed for pandemic response and are adopted globally by a wide range of users.

Track Iran's national COVID-19 response committee's major concerns using two-stage unsupervised topic modeling.

BACKGROUND: Since the World Health Organization (WHO) declared the COVID-19 as a Public Health Emergency of International Concern (PHEIC) on January 31, 2020, governments have been enfaced with crisis for timely responses. The efficacy of these responses directly depends on the social behaviors of the target society. People react to these actions with respect to the information they received from different channels, such as news and social networks. Thus, analyzing news demonstrates a brief view of the information users received during the outbreak. METHODS: The raw data used in this study is collected from official news channels of news wires and agencies in Telegram messenger, which exceeds 2,400,000 posts. The posts that are quoted by NCRC's members are collected, cleaned, and divided into sentences. The topic modeling and tracking are utilized in a two-stage framework, which is customized for this problem to separate miscellaneous sentences from those presenting concerns. The first stage is fed with embedding vectors of sentences where they are grouped by the Mapper algorithm. Sentences belonging to singleton nodes are labeled as miscellaneous sentences. The remained sentences are vectorized, adopting Tf-IDF weighting schema in the second stage and topically modeled by the LDA method. Finally, relevant topics are aligned to the list of policies and actions, named topic themes, that are set up by the NCRC. RESULTS: Our results show that major concerns presented in about half of the sentences are (1) PCR lab. test, diagnosis, and screening, (2) Closure of the education system, and (3) awareness actions about washing hands and facial mask usage. Among the eight themes, intra-provincial travel and traffic restrictions, as well as briefing the national and provincial status, are under-presented. The timeline of concerns annotated by the preventive actions illustrates the changes in concerns addressed by NCRC. This timeline shows that although the announcements and public responses are not lagged behind the events, but cannot be considered as timely. Furthermore, the fluctuating series of concerns reveal that the NCRC has not a long-time response map, and members react to the closest announced policy/act. CONCLUSION: The results of our study can be used as a quantitative indicator for evaluating the availability of an on-time public response of Iran's NCRC during the first three months of the outbreak. Moreover, it can be used in comparative studies to investigate the differences between awareness acts in various countries. Results of our customized-design framework showed that about one-third of the discussions of the NCRC's members cover miscellaneous topics that must be removed from the data.

[Information technology and digital health to support health in the time of CoViD-19.] / Information technology e digital health a supporto della salute ai tempi della CoViD-19.

The CoViD-19 pandemic has provided the opportunity for the health care's digital revolution with the unprecedented accelerated expansion of telehealth, telemedicine and other digital health tools. Several tools have been developed and launched at national and international level to face the emergency, including tools to perform online triage, symptoms checking, video visits and remote monitoring, and to conduct local and national epidemiological surveillance studies. Artificial intelligence-based tools have also been developed to diagnose cases of CoViD-19 or to identify patients at risk. Most of these technologies have been endorsed by medical societies such as the American Medical Association and the American Academy of Family Physicians which launched specific guidelines about their use. The growth in telemedicine services and in digital health technologies could not have occurred without important telehealth regulatory changes that have occurred in some countries aimed at promoting their use to face the CoViD-19 emergency, such as the deregulation of the use of video conferencing and video chat systems to carry out video visits, and the payment parity between telehealth and in clinic care. In order to decide whether to continue using these tools even after the pandemic is over, it could be useful to perform validation and efficacy studies of these tools to study their implications on the doctor-patient relationship, to understand if the new features can be integrated with the other technological tools already in use, and if they can improve clinical practice and quality of care.

Demand for Health Information on COVID-19 among Vietnamese.

Due to the rapid spread of coronavirus, Vietnam introduced its first national partial lockdown on April 1st, 2020. The public relied on online sources, whether through official websites or phone-based applications, to acquire up-to-date health information, provide accurate instructions, and limit misinformation. This study aims to provide insight regarding the current level of awareness of the pandemic, and to identify associated factors in Vietnamese participants to recommend necessary interventions. A cross-sectional study was conducted using a web-based survey during the first week of the lockdown period. There were 341 observations collected using a snowball sampling technique. A Tobit multivariable regression model was used to identify factors associated with the demand for each category of health information. The most requested information was the latest updated news on the epidemic, followed by information about disease symptoms and updated news on the outbreak. The prevalence of diverse socioeconomic, demographic, and ethnic factors in Vietnam requires consideration of the specific health information needs of unique groups. Identifying group-specific demands would be helpful to provide proper information to fulfill each population group's needs.

COVID-19 Information Seeking on Digital Media and Preventive Behaviors: The Mediation Role of Worry.

The high prevalence of novel coronavirus disease (COVID-19) and inefficient preventive measures taken to curb the disease are significant public health concerns. Rapid and innovative advances in digital media offer opportunities for health education, which could result in increased preventive behaviors. This study assessed preventive behaviors against contracting COVID-19 and tested mediation pathways linking four types of digital media consumption (social media, mobile social networking apps [MSNs], online news media, and social live steaming services [SLSSs]) to preventive behaviors, mediated by worry. Results from an online survey (N = 511) revealed that the vast majority (>90 percent) of respondents had very often or always practiced preventive behaviors against contracting COVID-19 such as washing their hands more regularly with soap and water, staying away from crowded places, and wearing face masks out in public. In addition, COVID-19 information seeking through the four types of digital media was a salient parameter that encouraged people to practice preventive behaviors either directly or indirectly. Specifically, seeking COVID-19-related information on MSNs, SLSSs, and online news media was directly associated with preventive behaviors. Whereas COVID-19 information consumption on social media, MSNs, and SLSSs during the infectious disease outbreak could elicit intense worry and, in turn, increase preventive behaviors. The reasons for and implications of the results are discussed.