bims-librar 2024-03-17 papers

bims-librar

Biomed News

on Biomedical librarianship

Issue of 2024–03–17
29 papers selected by
Thomas Krichel, Open Library Society

Public library lending programs increase radon testing in rural communities.
Librarian-Led Assessment of Medical Students' Evidence-Based Medicine Competency: Facilitators and Barriers.
You can go your own way: Conducting a signage audit in a health library.
Can large language models replace humans in systematic reviews? Evaluating GPT-4's efficacy in screening and extracting data from peer-reviewed and grey literature in multiple languages.
At Present, ChatGPT Cannot be Relied Upon to Answer Patient Questions and Requires Physician Expertise to Interpret Answers for Patients.
The performance of artificial intelligence chatbot large language models to address skeletal biology and bone health queries.
Manual versus machine: How accurately does the Medical Text Indexer (MTI) classify different document types into disease areas?
Large language models and bariatric surgery patient education: a comparative readability analysis of GPT-3.5, GPT-4, Bard, and online institutional resources.
Evaluating ChatGPT ability to answer urinary tract Infection-Related questions.
A systematic review of online resources for the dietary management of hyperphosphatemia in people with chronic kidney disease.
Conclusiveness, readability and textual characteristics of plain language summaries from medical and non-medical organizations: a cross-sectional study.
Analysis of patient-directed search content and online resource quality for ulnar collateral ligament injury and surgery.
A health literacy analysis of online patient-directed educational materials about mycobacterium avium complex.
Readability of online dermatology patient education resources.
Cosmetic Contact Lenses in the United Kingdom: Assessment of Online Regulation and Quality of Consumer Health Information.
Dietary phosphate educational materials for pediatric chronic kidney disease: are confused messages reducing their impact?
Evaluation of the Accuracy, Credibility, and Readability of Statin-Related Websites: Cross-Sectional Study.
Content Analysis of Food Safety Information in Apple-Drying Recipes from YouTube, Blogs, Cookbooks, and Extension Materials.
TikTok Videos Related to Rhinoplasty in China: Characteristics and the Quality of the Information.
Is it safe to learn about vital pulp capping from YouTube™ videos? A content and quality analysis.
Surgical videos on YouTube ™ are not peer reviewed and have low educational value.
Reliability and Usefulness of YouTube as a Source of Informative Media for Arthroscopic Tennis Elbow Surgery: A Systematic Review of the Published Videos.
Quality of Pelvic Floor Therapy Videos on YouTube: Does Popularity Predict Reliability?
Assessing the Quality and Clarity of YouTube Videos as an Informational Source for Ankle Fractures: A Study of the Turkish Population.
Information videos posted on Instagram by orthopaedics and sports traumatology surgeons mostly explain surgical technique, and the least mentioned topics are injury prevention and complications.
Online Health Information Seeking and Preventative Health Actions: Cross-Generational Online Survey Study.
Health information-seeking behavior of nursing students in Isfahan city about COVID-19 disease.
Information Seeking Behavior and Strategies to Increase Milk Supply Among Breastfeeding Mothers in the United States.
Health information sources and health-seeking behaviours of Filipinos living in medically underserved communities: Empirical quantitative research.

Libr Inf Sci Res. 2024 Jan;pii: 101283. [Epub ahead of print]46(1):

Public library lending programs increase radon testing in rural communities.

Stacy R Stanifer, Kathy Rademacher, Whitney Beckett, King Simpson, Mary Kay Rayens, Amanda Thaxton-Wiggins, Ellen J Hahn.

Radon exposure is the second leading cause of lung cancer, yet few Americans test their homes for radon, particularly in rural areas. The academic team and community partners engaged the public library systems in four rural counties to offer digital radon detectors for check-out as a means of increasing the public's access to free radon testing. The check-out procedures and instructional materials were created through an iterative process, and library personnel were educated on radon and home radon testing prior to launching the lending program. Library patrons reported high usability, feasibility, and acceptability of the program. Library patron-staff interactions mainly included discussions about the logistics of radon testing. Given that public libraries are invested in making communities thrive and promoting health, providing library lending programs for radon detectors is a novel, feasible, and acceptable way to reduce the risk of lung cancer in the community.

DOI: https://doi.org/10.1016/j.lisr.2024.101283
Perspect Med Educ. 2024 ;13(1): 160-168

Librarian-Led Assessment of Medical Students' Evidence-Based Medicine Competency: Facilitators and Barriers.

Joey Nicholson, Caitlin Plovnick, Cees van der Vleuten, Anique B H de Bruin, Adina Kalet.

Introduction: We must ensure, through rigorous assessment that physicians have the evidence-based medicine (EBM) skills to identify and apply the best available information to their clinical work. However, there is limited guidance on how to assess EBM competency. With a better understanding of their current role in EBM education, Health Sciences Librarians (HSLs), as experts, should be able to contribute to the assessment of medical student EBM competence. The purpose of this study is to explore the HSLs perspective on EBM assessment practices, both current state and potential future activities.
Methods: We conducted focus groups with librarians from across the United States to explore their perceptions of assessing EBM competence in medical students. Participants had been trained to be raters of EBM competence as part of a novel Objective Structured Clinical Examination (OSCE). This OSCE was just the starting point and the discussion covered topics of current EBM assessment and possibility for expanded responsibilities at their own institutions. We used a reflexive thematic analysis approach to construct themes from our conversations.
Results: We constructed eight themes in four broad categories that influence the success of librarians being able to engage in effective assessment of EBM: administrative, curricular, medical student, and librarian.
Conclusion: Our results inform medical school leadership by pointing out the modifiable factors that enable librarians to be more engaged in conducting effective assessment. They highlight the need for novel tools, like EBM OSCEs, that can address multiple barriers and create opportunities for deeper integration of librarians into assessment processes.

DOI: https://doi.org/10.5334/pme.1145
Health Info Libr J. 2024 Mar 14.

You can go your own way: Conducting a signage audit in a health library.

Katie Wise.

   BACKGROUND: The Library and Knowledge Services at the Royal Berkshire NHS Foundation Trust has been at its current location since 1975 and, in September 2020, it was deemed necessary to examine the library environment and assess the signage.
OBJECTIVES: The main objective was to conduct a methodical assessment of all the current library signage in order to improve the library environment, wayfinding, and clarity.
METHODS: A methodical signage audit was conducted by library staff, photographing signs, assigning them to categories, and creating a signage map.
RESULTS: In total, 58 different signs were counted in the library. Of these, 22 signs were deemed satisfactory, 4 should be moved to a more appropriate location, 15 should be updated with a branded design and better messaging, and 17 were recommended for removal.
DISCUSSION: The results demonstrated that there were three main areas where signage could be improved: reducing the quantity of signs, updating the language and design, and the use of ad hoc signage.
CONCLUSION: By assessing the signs and assigning categories and types, areas were identified as problem points that were impacting the library user's experience and small changes were implemented to improve the library environment.

Keywords:  accessing information; auditing; information seeking behaviours; library administration; library services

DOI:  https://doi.org/10.1111/hir.12525
Res Synth Methods. 2024 Mar 14.

Can large language models replace humans in systematic reviews? Evaluating GPT-4's efficacy in screening and extracting data from peer-reviewed and grey literature in multiple languages.

Qusai Khraisha, Sophie Put, Johanna Kappenberg, Azza Warraitch, Kristin Hadfield.

  Systematic reviews are vital for guiding practice, research and policy, although they are often slow and labour-intensive. Large language models (LLMs) could speed up and automate systematic reviews, but their performance in such tasks has yet to be comprehensively evaluated against humans, and no study has tested Generative Pre-Trained Transformer (GPT)-4, the biggest LLM so far. This pre-registered study uses a "human-out-of-the-loop" approach to evaluate GPT-4's capability in title/abstract screening, full-text review and data extraction across various literature types and languages. Although GPT-4 had accuracy on par with human performance in some tasks, results were skewed by chance agreement and dataset imbalance. Adjusting for these caused performance scores to drop across all stages: for data extraction, performance was moderate, and for screening, it ranged from none in highly balanced literature datasets (~1:1) to moderate in those datasets where the ratio of inclusion to exclusion in studies was imbalanced (~1:3). When screening full-text literature using highly reliable prompts, GPT-4's performance was more robust, reaching "human-like" levels. Although our findings indicate that, currently, substantial caution should be exercised if LLMs are being used to conduct systematic reviews, they also offer preliminary evidence that, for certain review tasks delivered under specific conditions, LLMs can rival human performance.

Keywords:  GPT; artificial intelligence (AI); large language models (LLMs); machine learning; natural language processing (NLP); systematic reviews

DOI:  https://doi.org/10.1002/jrsm.1715
Arthroscopy. 2024 Mar 12. pii: S0749-8063(24)00194-4. [Epub ahead of print]

At Present, ChatGPT Cannot be Relied Upon to Answer Patient Questions and Requires Physician Expertise to Interpret Answers for Patients.

Eoghan T Hurley, Bryan S Crook, Jonathan F Dickens.

ChatGPT is designed to provide accurate and reliable information to the best of its abilities based on the data input and knowledge available. Thus, ChatGPT is being studied as a patient information tool. This artificial intelligence (AI) tool has been shown to frequently provide technically correct information, but with limitations. ChatGPT provides different answers to similar questions based on the prompts, and patients may not have expertise in prompting ChattPT to elicit a best answer. (Prompting large language models has been shown to be a skill that can improve). Of greater concern, ChatGPT fails to provide sources or references for its answers. At present ChatGPT cannot be relied upon to address patient questions; in the future, ChatGPT will improve. Today, AI requires physician expertise to interpret AI answers for patients.

DOI: https://doi.org/10.1016/j.arthro.2024.02.039
J Bone Miner Res. 2024 Jan 04. pii: zjad007. [Epub ahead of print]

The performance of artificial intelligence chatbot large language models to address skeletal biology and bone health queries.

Michelle Cung, Branden Sosa, He S Yang, Michelle M McDonald, Brya G Matthews, Annegreet G Vlug, Erik A Imel, Marc N Wein, Emily Margaret Stein, Matthew B Greenblatt.

  Artificial intelligence (AI) chatbots utilizing large language models (LLMs) have recently garnered significant interest due to their ability to generate humanlike responses to user inquiries in an interactive dialog format. While these models are being increasingly utilized to obtain medical information by patients, scientific and medical providers, and trainees to address biomedical questions, their performance may vary from field to field. The opportunities and risks these chatbots pose to the widespread understanding of skeletal health and science are unknown. Here we assess the performance of 3 high-profile LLM chatbots, Chat Generative Pre-Trained Transformer (ChatGPT) 4.0, BingAI, and Bard, to address 30 questions in 3 categories: basic and translational skeletal biology, clinical practitioner management of skeletal disorders, and patient queries to assess the accuracy and quality of the responses. Thirty questions in each of these categories were posed, and responses were independently graded for their degree of accuracy by four reviewers. While each of the chatbots was often able to provide relevant information about skeletal disorders, the quality and relevance of these responses varied widely, and ChatGPT 4.0 had the highest overall median score in each of the categories. Each of these chatbots displayed distinct limitations that included inconsistent, incomplete, or irrelevant responses, inappropriate utilization of lay sources in a professional context, a failure to take patient demographics or clinical context into account when providing recommendations, and an inability to consistently identify areas of uncertainty in the relevant literature. Careful consideration of both the opportunities and risks of current AI chatbots is needed to formulate guidelines for best practices for their use as source of information about skeletal health and biology.

Keywords:  Bard; BingAI; ChatGPT; artificial intelligence; large language models; skeletal biology

DOI:  https://doi.org/10.1093/jbmr/zjad007
PLoS One. 2024 ;19(3): e0297526

Manual versus machine: How accurately does the Medical Text Indexer (MTI) classify different document types into disease areas?

Duncan A Q Moore, Ohid Yaqub, Bhaven N Sampat.

The Medical Subject Headings (MeSH) thesaurus is a controlled vocabulary developed by the U.S. National Library of Medicine (NLM) for classifying journal articles. It is increasingly used by researchers studying medical innovation to classify text into disease areas and other categories. Although this process was once manual, human indexers are now assisted by algorithms that automate some of the indexing process. NLM has made one of their algorithms, the Medical Text Indexer (MTI), available to researchers. MTI can be used to easily assign MeSH descriptors to arbitrary text, including from document types other than publications. However, the reliability of extending MTI to other document types has not been studied directly. To assess this, we collected text from grants, patents, and drug indications, and compared MTI's classification to expert manual classification of the same documents. We examined MTI's recall (how often correct terms were identified) and found that MTI identified 78% of expert-classified MeSH descriptors for grants, 78% for patents, and 86% for drug indications. This high recall could be driven merely by excess suggestions (at an extreme, all diseases being assigned to a piece of text); therefore, we also examined precision (how often identified terms were correct) and found that most MTI outputs were also identified by expert manual classification: precision was 53% for grant text, 73% for patent text, and 64% for drug indications. Additionally, we found that recall and precision could be improved by (i) utilizing ranking scores provided by MTI, (ii) excluding long documents, and (iii) aggregating to higher MeSH categories. For simply detecting the presence of any disease, MTI showed > 94% recall and > 87% precision. Our overall assessment is that MTI is a potentially useful tool for researchers wishing to classify texts from a variety of sources into disease areas.

DOI: https://doi.org/10.1371/journal.pone.0297526
Surg Endosc. 2024 Mar 12.

Large language models and bariatric surgery patient education: a comparative readability analysis of GPT-3.5, GPT-4, Bard, and online institutional resources.

Nitin Srinivasan, Jamil S Samaan, Nithya D Rajeev, Mmerobasi U Kanu, Yee Hui Yeo, Kamran Samakar.

   BACKGROUND: The readability of online bariatric surgery patient education materials (PEMs) often surpasses the recommended 6th grade level. Large language models (LLMs), like ChatGPT and Bard, have the potential to revolutionize PEM delivery. We aimed to evaluate the readability of PEMs produced by U.S. medical institutions compared to LLMs, as well as the ability of LLMs to simplify their responses.
METHODS: Responses to frequently asked questions (FAQs) related to bariatric surgery were gathered from top-ranked health institutions. FAQ responses were also generated from GPT-3.5, GPT-4, and Bard. LLMs were then prompted to improve the readability of their initial responses. The readability of institutional responses, initial LLM responses, and simplified LLM responses were graded using validated readability formulas. Accuracy and comprehensiveness of initial and simplified LLM responses were also compared.
RESULTS: Responses to 66 FAQs were included. All institutional and initial LLM responses had poor readability, with average reading levels ranging from 9th grade to college graduate. Simplified responses from LLMs had significantly improved readability, with reading levels ranging from 6th grade to college freshman. When comparing simplified LLM responses, GPT-4 responses demonstrated the highest readability, with reading levels ranging from 6th to 9th grade. Accuracy was similar between initial and simplified responses from all LLMs. Comprehensiveness was similar between initial and simplified responses from GPT-3.5 and GPT-4. However, 34.8% of Bard's simplified responses were graded as less comprehensive compared to initial.
CONCLUSION: Our study highlights the efficacy of LLMs in enhancing the readability of bariatric surgery PEMs. GPT-4 outperformed other models, generating simplified PEMs from 6th to 9th grade reading levels. Unlike GPT-3.5 and GPT-4, Bard's simplified responses were graded as less comprehensive. We advocate for future studies examining the potential role of LLMs as dynamic and personalized sources of PEMs for diverse patient populations of all literacy levels.

Keywords:  Bard; Bariatric surgery; GPT-3.5; GPT-4; Large language models; Readability

DOI:  https://doi.org/10.1007/s00464-024-10720-2
Infect Dis Now. 2024 Mar 08. pii: S2666-9919(24)00039-3. [Epub ahead of print]54(4): 104884

Evaluating ChatGPT ability to answer urinary tract Infection-Related questions.

Hakan Cakir, Ufuk Caglar, Sami Sekkeli, Esra Zerdali, Omer Sarilar, Oguzhan Yildiz, Faruk Ozgor.

   INTRODUCTION: For the first time, the accuracy and proficiency of ChatGPT answers on urogenital tract infection (UTIs) were evaluated.
METHODS: The study aimed to create two lists of questions: frequently asked questions (FAQs, public-based inquiries) on relevant topics, and questions based on guideline information (guideline-based inquiries). ChatGPT responses to FAQs and scientific questions were scored by two urologists and an infectious disease specialist. Quality and reliability of all ChatGPT answers were checked using the Global Quality Score (GQS). The reproducibility of ChatGPT answers was analyzed by asking each question twice.
RESULTS: All in all, 96.2 % of FAQs (75/78 inquiries) related to UTIs were correctly and adequately answered by ChatGPT, and scored GQS 5. None of the ChatGPT answers were classified as GQS 2 and GQS 1. Moreover, FAQs about cystitis, urethritis, and epididymo-orchitis were answered by ChatGPT with 100 % accuracy (GQS 5). ChatGPT answers for EAU urological infections guidelines showed that 61 (89.7 %), 5 (7.4 %), and 2 (2.9 %) ChatGPT responses were scored GQS 5, GQS 4, and GQS 3, respectively. None of the ChatGPT responses for EAU urological infections guidelines were categorized as GQS 2 and GQS 1. Comparison of mean GQS values of ChatGPT answers for FAQs and EAU urological guideline questions showed that ChatGPT was similarly able to respond to both question groups (p = 0.168). The ChatGPT response reproducibility rate was highest for the FAQ subgroups of cystitis, urethritis, and epididymo-orchitis (100 % for each subgroup).
CONCLUSION: The present study showed that ChatGPT gave accurate and satisfactory answers for both public-based inquiries, and EAU urological infection guideline-based questions. Reproducibility of ChatGPT answers exceeded 90% for both FAQs and scientific questions.

Keywords:  Artificial intelligence; ChatGPT; Guideline; Infection; Urinary tract infection

DOI:  https://doi.org/10.1016/j.idnow.2024.104884
J Ren Nutr. 2024 Mar 12. pii: S1051-2276(24)00033-5. [Epub ahead of print]

A systematic review of online resources for the dietary management of hyperphosphatemia in people with chronic kidney disease.

Most Murshida Begum, Annabel Biruete, Brandon Kistler, Anthony Meade, John Westhoff, David E St-Jules.

   OBJECTIVE: Internet search engines and social media websites are prominent and growing sources of dietary information for people with chronic kidney disease (CKD) and their healthcare providers. However, nutrition therapy for CKD is undergoing a paradigm shift, which may lead to inconsistent advice for managing hyperphosphatemia. The aim of this study was to summarize and evaluate online resources for phosphorus-specific nutrition therapy.
DESIGN AND METHODS: Patient-facing resources were collected from Google, Yahoo, and Facebook in June-July 2021. Using nine independent search terms, the first 100 hits were reviewed. Dietary advice for food types, food groups, food sub-groups, and individual food items was categorized as "restricted," "recommended," "mixed," and "not mentioned". Information on publication date, source, and author(s), phosphorus bioavailability and demineralization were also collected.
RESULTS: After removing duplicates, 199 resources from Google and Yahoo, and 33 from Facebook were reviewed. Resources ranged from 2005 to 2021, and were primarily authored by registered dietitians and medical doctors (65% and 31%, respectively). Dietary advice mostly focused on restricting high-phosphorus foods, and phosphorus additive-based processed foods. Dietary restrictions were generally consistent with the traditional low-phosphorus diet, which targets whole grains, Dairy, and plant-based Protein Foods, although major inconsistencies were noted. Phosphorus bioavailability and demineralization were rarely mentioned (16% and 8%, respectively). Similar findings were found on Facebook, but the limited number of resources limited meaningful comparisons.
CONCLUSION: Results showed that online resources for phosphorus-specific nutrition therapy are highly restrictive of heart healthy food items. and contain significant inconsistencies. Given the widespread and increasing use of online resources by people with CKD and healthcare professionals to inform dietary choices, efforts are urgently needed to establish consensus for phosphorus-specific nutrition therapy. Until then, the findings of this study provide a basis for increasing awareness of the potential for confusion arising from online resources.

Keywords:  Chronic kidney disease; hyperphosphatemia; low-phosphorus diet; online resources

DOI:  https://doi.org/10.1053/j.jrn.2024.01.005
Sci Rep. 2024 03 12. 14(1): 6016

Conclusiveness, readability and textual characteristics of plain language summaries from medical and non-medical organizations: a cross-sectional study.

Nensi Bralić, Antonija Mijatović, Ana Marušić, Ivan Buljan.

This cross-sectional study compared plain language summaries (PLSs) from medical and non-medical organizations regarding conclusiveness, readability and textual characteristics. All Cochrane (medical PLSs, n = 8638) and Campbell Collaboration and International Initiative for Impact Evaluation (non-medical PLSs, n = 163) PLSs of latest versions of systematic reviews published until 10 November 2022 were analysed. PLSs were classified into three conclusiveness categories (conclusive, inconclusive and unclear) using a machine learning tool for medical PLSs and by two experts for non-medical PLSs. A higher proportion of non-medical PLSs were conclusive (17.79% vs 8.40%, P < 0.0001), they had higher readability (median number of years of education needed to read the text with ease 15.23 (interquartile range (IQR) 14.35 to 15.96) vs 15.51 (IQR 14.31 to 16.77), P = 0.010), used more words (median 603 (IQR 539.50 to 658.50) vs 345 (IQR 202 to 476), P < 0.001). Language analysis showed that medical PLSs scored higher for disgust and fear, and non-medical PLSs scored higher for positive emotions. The reason for the observed differences between medical and non-medical fields may be attributed to the differences in publication methodologies or disciplinary differences. This approach to analysing PLSs is crucial for enhancing the overall quality of PLSs and knowledge translation to the general public.

DOI: https://doi.org/10.1038/s41598-024-56727-6
JSES Int. 2024 Mar;8(2): 384-388

Analysis of patient-directed search content and online resource quality for ulnar collateral ligament injury and surgery.

Johnathon R McCormick, William E Harkin, Alexander J Hodakowski, John T Streepy, Zeeshan A Khan, Colton C Mowers, Braedon R Urie, Harkirat S Jawanda, Garrett R Jackson, Jorge Chahla, Grant E Garrigues, Nikhil N Verma.

   Background: Patients use the Internet to learn information about injuries, yet online content remains largely unstudied. This study analyzed patient questions posed online regarding ulnar collateral ligament (UCL) tears or UCL surgical management.
Methods: Three separate search strings about UCL tear and UCL surgery were queried on the Google search engine. The 300 most commonly asked questions were compiled for each topic and associated webpage information was collected from the "People also ask" section. Questions were categorized using the Rothwell classification and webpages by Journal of the American Medical Association (JAMA) benchmark criteria.
Results: The most frequent UCL tear questions were "how long does it take to heal a torn UCL?" and "what is nonsurgical treatment for the UCL?" The most frequent UCL surgery question was "can you retear your UCL after surgery?" The Rothwell classification of questions for UCL tear/UCL surgery was 55%/32% policy, 38%/57% fact, and 7%/11% value with highest subcategories being indications/management (46%/25%) and technical details (24%/25%). The most common webpages were academic (39%/29%) and medical practice (24%/26%). Mean JAMA score for all 600 webpages was low (1.2), with journals (mean = 3.4) having the highest score. Medical practice (mean = 0.5) and legal websites (mean = 0.0) had the lowest JAMA scores. Only 30% of webpages provided UCL-specific information.
Conclusion: Online UCL patient questions commonly pertain to technical details and injury management. Webpages suggested by search engines contain information specific to UCL tears and surgery only one-third of the time. The quality of most webpages provided to patients is poor, with minimal source transparency.

Keywords:  Google; Online questions; Patient education; People also ask; Ulnar collateral ligament surgery; Ulnar collateral ligament tear

DOI:  https://doi.org/10.1016/j.jseint.2023.11.017
J Clin Tuberc Other Mycobact Dis. 2024 May;35 100424

A health literacy analysis of online patient-directed educational materials about mycobacterium avium complex.

Olabimpe Asupoto, Shamsuddin Anwar, Alysse G Wurcel.

   Introduction: Mycobacterium avium complex (MAC) is a complex lung infection requiring multi-disciplinary approach and management. Due to limited clinician-patient interactions, clinicians may refer patients to online resources to learn about the diagnosis, prognosis, and treatment of MAC. The American Medical Association (AMA) recommends educational materials be written at a sixth-grade reading level and the National Institutes of Health (NIH) recommends that patient education materials be written at an eighth-grade reading level; however, several evaluations found these materials inaccessible due to high literacy levels. To date, there has never been a health literacy assessment of MAC patient education materials. The study aims to assess the health literacy of online patient education materials about MAC.
Methods: The patient education materials were evaluated for readability, actionability, understandability and clarity. Readability was assessed through the Flesch-Kincaid Grade Level Scale (FkGL), SMOG Index, Coleman Liau Index (CLI), Gunning Fog Index (GFI), and Automated Readability Index (ARI). Actionability and understandability was evaluated using the Patient Education Materials Assessment Tool (PEMAT). The Centers for Disease Control (CDC) Clear Communication Index (CCI) was used to assess clarity.
Results: Ten patient education resources were evaluated: CDC, Cleveland Clinic, Mayo Clinic, JAMA, American Thoracic Society (ATS), National Jewish Health, UpToDate, CHEST, WebMD, and Medline. The mean readability scores were as follows: FkGL (9.76), SMOG index (9.82), CLI (13.54), GFI (11.66), ARI (9.15). Four patient education materials were written at a sixth-grade reading level and eight patient education materials were written at an eighth-grade reading level. The majority of the materials received a passing score for understandability but failed to achieve a passing score for actionability. Cleveland Clinic, JAMA, and ATS all received a passing clarity score, indicating that they are easy to read. No patient education materials were available on UpToDate.
Conclusion: Most patient education materials scored poorly for actionability and clarity while scoring highly for readability and understandability. This study should serve as a guide for clinicians interested in offering online education materials to their patients. Increasing access to readable MAC educational materials should be a priority for those working at the intersection of public health, clinical care, and communications.

Keywords:  Health literacy; Infectious diseases; Mycobacterium avium complex; Patient education; Pulmonary disease

DOI:  https://doi.org/10.1016/j.jctube.2024.100424
J Eur Acad Dermatol Venereol. 2024 Mar 11.

Readability of online dermatology patient education resources.

Nicole Natarelli, Lynn Nguyen, Elizabeth Botto, Emily Coughlin, Amanda Krenitsky, Sharon Albers.

DOI: https://doi.org/10.1111/jdv.19944
Eye Contact Lens. 2024 Mar 13.

Cosmetic Contact Lenses in the United Kingdom: Assessment of Online Regulation and Quality of Consumer Health Information.

Benjamin Ng, Matthew Azzopardi, Alice Ditchfield, Jin Zi, Abison Logeswaran, Imogen Hawthorne, Darren S J Ting, Yu Jeat Chong.

OBJECTIVES: To determine the compliance of online vendors to the UK Opticians Act 1989 Section 27 requirements and safety regulations for cosmetic contact lens (CCL) sales and the quality of online CCL health information.
METHODS: The top 50 websites selling CCLs on each three search engines, namely Google, Yahoo, and Bing, were selected. Duplicates were removed, and the remaining websites were systematically analyzed in February 2023. UK legal authorization for CCL sales was assessed using the Opticians Act Section 27 and safety regulations determined by the presence of Conformité Européene (CE) marking. The quality and reliability of online information was graded using the DISCERN (16-80) and JAMA (0-4) scores by two independent reviewers.
RESULTS: Forty-seven eligible websites were analyzed. Only six (12.7%) met the UK legal authorization for CCL sales. Forty-nine different brands of CCLs were sold on these websites, of which 13 (26.5%) had no CE marking. The mean DISCERN and JAMA benchmark scores were 26 ± 12.2 and 1.3 ± 0.6, respectively (intraclass correlation scores: 0.99 for both).
CONCLUSIONS: A significant number of websites provide consumers with easy, unsafe, and unregulated access to CCLs. Most online stores do not meet the requirements set out in the Opticians Act for CCL sales in the United Kingdom. A significant number of CCLs lack CE marking, while the average quality of information on websites selling CCLs is poor. Together, these pose a risk to consumers purchasing CCLs from unregulated websites, and therefore, further stringent regulations on the online sales of these products are needed.

DOI: https://doi.org/10.1097/ICL.0000000000001080
J Ren Nutr. 2024 Mar 12. pii: S1051-2276(24)00035-9. [Epub ahead of print]

Dietary phosphate educational materials for pediatric chronic kidney disease: are confused messages reducing their impact?

Louise McAlister, Vanessa Shaw, Rukshana Shroff.

   OBJECTIVE: This study aimed to review the quality and content of phosphate educational materials used in pediatric chronic kidney disease.
METHODS: The quality of text-based pediatric phosphate educational materials was assessed using validated instruments for health literacy demands (Suitability Assessment of Materials [SAM] and Patient Education Material Assessment Tool [PEMAT-P]) and readability (Flesch Reading Ease [FRE] and Flesch-Kincaid [FK] Grade Level). Codes were inductively derived to analyse format, appearance, target audience, resource type and content, aiming for an intercoder reliability (ICR) >80%. The content was compared to Paediatric Renal Nutrition Taskforce (PRNT) recommendations.
RESULTS: Sixty-five phosphate educational materials were obtained, 37 were pediatric-focused including 28 text-based. Thirty-two percent of text-based materials were directed at caregivers, 25% children and 43% unspecified. Most (75%) included a production date with 75% produced >2 years ago. The median FRE test-score was 68.2 (interquartile range [IQR] 61.1-75.3) and FK Grade Level 5.6 (IQR 4.5-7.7). Using SAM, 54% rated "superior" (≥70), 38% "adequate" (40-69) and 8% "not suitable" (≤39). Low scoring materials lacked a summary (12%), cover graphics (35%) or included irrelevant illustrations (50%). PEMAT-P scores were 70% (IQR 50-82) for understandability and 50% (IQR 33-67) for actionability. An ICR of 87% was achieved. Over half limited foods in agreement with PRNT (including 89% suggesting avoiding phosphate additives). Recommendations conflicting with PRNT included reducing legumes and wholegrains. Over a third contained inaccuracies and over two thirds included no practical advice.
CONCLUSIONS: Text-based pediatric phosphate educational materials are pitched at an appropriate level for caregivers, but this may be too high for children under 10 years. The inclusion of relevant illustrations may improve this. Three quarters of materials scored low for actionability. The advice does not always align with the PRNT, which (together with the inaccuracies reported) could result in conflicting messages to patients and their families.

Keywords:  CKD; diet; hyperphosphatemia; patient education material; phosphate

DOI:  https://doi.org/10.1053/j.jrn.2024.02.004
Interact J Med Res. 2024 Mar 14. 13 e42849

Evaluation of the Accuracy, Credibility, and Readability of Statin-Related Websites: Cross-Sectional Study.

Eunice Ling, Domenico de Pieri, Evenne Loh, Karen M Scott, Stephen C H Li, Heather J Medbury.

   BACKGROUND: Cardiovascular disease (CVD) represents the greatest burden of mortality worldwide, and statins are the most commonly prescribed drug in its management. A wealth of information pertaining to statins and their side effects is on the internet; however, to date, no assessment of the accuracy, credibility, and readability of this information has been undertaken.
OBJECTIVE: This study aimed to evaluate the quality (accuracy, credibility, and readability) of websites likely to be visited by the general public undertaking a Google search of the side effects and use of statin medications.
METHODS: Following a Google web search, we reviewed the top 20 consumer-focused websites with statin information. Website accuracy, credibility, and readability were assessed based on website category (commercial, not-for-profit, and media), website rank, and the presence or absence of the Health on the Net Code of Conduct (HONcode) seal. Accuracy and credibility were assessed following the development of checklists (with 20 and 13 items, respectively). Readability was assessed using the Simple Measure of Gobbledegook scores.
RESULTS: Overall, the accuracy score was low (mean 14.35 out of 20). While side effects were comprehensively covered by 18 websites, there was little information about statin use in primary and secondary prevention. None of the websites met all criteria on the credibility checklist (mean 7.8 out of 13). The median Simple Measure of Gobbledegook score was 9.65 (IQR 8.825-10.85), with none of the websites meeting the recommended reading grade of 6, even the media websites. A website bearing the HONcode seal did not mean that the website was more comprehensive or readable.
CONCLUSIONS: The quality of statin-related websites tended to be poor. Although the information contained was accurate, it was not comprehensive and was presented at a reading level that was too difficult for an average reader to fully comprehend. As such, consumers risk being uninformed about this pharmacotherapy.

Keywords:  accuracy; cardiovascular; consumer health information; credibility; digital health, health information seeking; management; medication; mortality; pharmacotherapy; readability; risk; statins

DOI:  https://doi.org/10.2196/42849
Foods. 2024 Mar 01. pii: 778. [Epub ahead of print]13(5):

Content Analysis of Food Safety Information in Apple-Drying Recipes from YouTube, Blogs, Cookbooks, and Extension Materials.

Megan Low, Yaohua Feng.

  Recurrent foodborne outbreaks associated with low-moisture foods prompted this study to evaluate apple-handling practices presented in apple-drying recipes available to United States consumers, and to explore the food safety implications of the recipes. Because little research is available on the safety of home fruit-drying, we conducted a systematic search of English-language apple-drying recipes from YouTube videos, blog articles, cookbooks, and university extension sources. Our evaluation found that most recipes excluded handwashing instructions, and potential cross-contamination practices were evident in 12% of the videos. Bruised or damaged apples were selected for drying in 16% of the videos, two blogs, and five cookbook recipes. Although more than half the blogs and videos demonstrated pre-treatment procedures, they did so predominantly to minimize browning with almost no mention of antimicrobial benefits. Drying temperature information was missing in 41% of the videos and 35% of the cookbooks that we evaluated. Even when temperatures were mentioned, most were insufficient for pathogen reduction according to the recommendations of previous studies. These videos, blogs, and cookbooks commonly advocated subjective indicators instead of unit measurements when slicing apples and checking for doneness. Our findings reveal the need for drastic improvements in food safety information dissemination to home apple-dryers and recipe developers.

Keywords:  apple-drying recipes; apple-handling practices; foodborne outbreaks

DOI:  https://doi.org/10.3390/foods13050778
Aesthetic Plast Surg. 2024 Mar 13.

TikTok Videos Related to Rhinoplasty in China: Characteristics and the Quality of the Information.

Kai Chen, Yuan Cai, Luyun Jiang.

   BACKGROUND: There are numerous videos related to rhinoplasty on TikTok in China. The objective is to examine videos on Chinese TikTok regarding rhinoplasty surgery and evaluate the content quality of rhinoplasty-related videos on TikTok.
METHOD: We collected 184 Chinese video samples related to rhinoplasty and extracted basic information. We used the PEMAT-A/V tool to evaluate each video.
RESULTS: A total of 184 videos were included in the study. The sampled videos received approximately 4.8 million likes, 900,000 comments, and 300,000 favorites. Most of the videos (n = 130, 70.65%) were posted by certified plastic surgeons on the TikTok platform. This study found that 6 (3.26%) videos contained obvious errors or misleading information. Regarding the PEMAT-A/V, the median total score was 85.71 (n = 184, IQR = 78.57-92.45%). Videos created by plastic surgeons had the highest comprehension score (n = 130, median = 100%, IQR = 91.67-100%), while videos from news media (n = 16, median = 75%, IQR = 70.76-77.34%) had the lowest usability and PEMAT-A/V total scores. In terms of video content, the PEMAT-A/V total score for surgical risks/contraindications related content (n = 15, median = 92.86%, IQR = 83.48-92.86%) was the highest, while scores for complaint-related content (n = 20, median = 75, IQR = 71.43-78.57%) were the lowest.
CONCLUSIONS: This study is the first report in China to evaluate the quality of information in nose plastic surgery-related videos on TikTok. We found that the quality of videos created by plastic surgeons on the TikTok platform is generally high, while videos provided by news media have lower quality. We encourage healthcare professionals to share more high-quality information on TikTok and educate patients on how to properly handle misinformation.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords:  Information quality; Rhinoplasty; Social media; TikTok

DOI:  https://doi.org/10.1007/s00266-024-03940-3
Int J Med Inform. 2024 Mar 09. pii: S1386-5056(24)00072-8. [Epub ahead of print]185 105409

Is it safe to learn about vital pulp capping from YouTube™ videos? A content and quality analysis.

Celalettin Topbaş, Tuğçe Paksoy, Ayşe Gülnihal İslamoğlu, Kemal Çağlar, Abdurrahman Kerim Kul.

   AIM: To evaluate YouTube videos on vital pulp capping (VPC) for content, quality, source, usefulness, and reliability.
MATERIALS AND METHODS: This study assessed 249 English-language videos on vital pulp therapy using the Total Content Score (TCS), Video Information and Quality Index (VIQI), Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) score and modified DISCERN score. Videos were categorized based on communication quality, duration, likes and dislikes, views, source, and video type. Of the videos analyzed, 22.1% met the inclusion criteria. Data were analyzed using Shapiro-Wilk, Kruskal-Wallis, and post hoc Bonferroni tests. Sperman's correlation, Kendal tau tests for correlations, and Fisher's exact test were used to assess associations between categorical variables.
RESULTS: The study identified significant correlations between various parameters. A higher TCS was correlated with increased VIQI (p = 0.005) and GQS scores (r = 0.685, p < 0.05). A moderate positive correlation was found between GQS scores and TCSs (r = 0.577, p < 0.05). VIQI scores were significantly and positively correlated with TCS (r = 0.573, p < 0.05) and comment count (r = 0.306, p < 0.05). JAMA scores were positively correlated with upload time (r = 0.304, p < 0.05), comment count (r = 0.337, p < 0.05), and likes (r = 0.301, p = 0.05).
CONCLUSIONS: YouTube videos provided low-to-average quality VPC information and tended to be inaccurate. Therefore, public videos may be incorrect, incomplete, and low-quality. Clinicians and patients should seek reliable information from specialists.

Keywords:  E-health; Social media; Vital pulp capping; YouTube

DOI:  https://doi.org/10.1016/j.ijmedinf.2024.105409
Arthroscopy. 2024 Mar 09. pii: S0749-8063(24)00179-8. [Epub ahead of print]

Surgical videos on YouTube ™ are not peer reviewed and have low educational value.

Nichole M Perry, John J Kelly, Bruce A Levy.

The rise of online platforms like YouTube for health information has prompted scrutiny over the quality of medical/surgical related video content. Recent research on YouTube videos regarding anterior cruciate ligament reconstruction (ACL-R) with quadriceps tendon (QT) autograft shows low educational quality and reliability using established assessment tools. Physicians primarily published content, with longer videos, and physician generated videos, generally correlating with higher quality. However, YouTube's inadequacy as a reliable source for ACL-R information underscores the need for alternative educational resources. Orthopaedic health care professionals must play a pivotal role in guiding patients toward credible sources and take aim at improving online content quality. Understanding patient preferences for online resources is essential for enhancing patient education, patient-provider relationship, and decision-making in orthopaedic care.

DOI: https://doi.org/10.1016/j.arthro.2024.03.006
J West Afr Coll Surg. 2024 Jan-Mar;14(1):14(1): 26-34

Reliability and Usefulness of YouTube as a Source of Informative Media for Arthroscopic Tennis Elbow Surgery: A Systematic Review of the Published Videos.

Arghya Kundu Choudhury, Shivam Bansal, Balgovind S Raja, Souvik Paul, Sachin Chaubey, Roop Bhushan Kalia.

   Aims and Objectives: Over the last decade, YouTube has been extensively used as a learning tool for both physicians and patients, but the reliability of this information remains questionable. The purpose of this study was to look for the reliability and quality of videos on tennis elbow arthroscopy on YouTube.
Materials and Methods: We used three search terms on YouTube "tennis elbow arthroscopic surgery," "Arthroscopic ECRB release," and "Arthroscopic debridement for tennis elbow," and screened the first 50 videos according to popularity. The videos were included from 2009 to date. Only videos in the English language were included. Repeated videos and videos without sound were excluded. A total of 74 videos were selected for this study and reliability was checked with DISCERN and journal of the American medical association (JAMA) scores. The quality was assessed with the Global Quality Score Criteria (GQSC) score and TEARS (a novel score). Popularity was tested with the video power index (VPI). A pilot study was conducted using 20 videos to validate the TEARS score.
Results: In the pilot study, TEARS showed results in accordance with other scores used. The average number of views was 41,644.97, and the average duration was 5.03 ± 3.39 years. The mean value of DISCERN and JAMA was found to be 21.47 ± 6.28 and 1.05 ± 0.92, respectively. GQSC, TEARS, and VPI were found to be 1.70 ± 0.82, 4.17 ± 2.62, and 769,936.9 ± 6,538,851.37.
Conclusion: Most of the videos were educational and physicians were targeted. The USA was the major contributor to such videos. The reliability and quality of these videos were found to be of poor quality. The video popularity was however found to be relatively high. The inter-observer reliability was good. Based on the findings, we conclude that the videos are not reliable and could not be used for learning.

Keywords:  Arthroscopic elbow debridement; ECRB debridement; ECRB release; arthroscopic elbow release; elbow arthroscopy; lateral epicondylitis; tennis elbow

DOI:  https://doi.org/10.4103/jwas.jwas_18_23
Urogynecology (Phila). 2024 Mar 01. 30(3): 233-238

Quality of Pelvic Floor Therapy Videos on YouTube: Does Popularity Predict Reliability?

Shanaya Shah, Erica Eggers, Krystal Hunter, Lioudmila Lipetskaia.

ABSTRACT: This study reviewed instructional videos on YouTube regarding pelvic floor physical therapy and assessed the association between the videos' popularity and the reliability of the videos' content. YouTube was searched using the terms relevant to pelvic floor muscle training. The first 100 videos for each search term were screened, and relevant metrics were collected for those meeting the inclusion criteria. Videos were assessed by 2 independent, trained health care professionals for reliability using the Medical Quality Video Evaluation (MQ-VET) tool, the modified DISCERN tool, the Journal of American Medical Association benchmark criteria, and the Global Quality Score. Popularity was assessed using the Video Power Index (VPI). Higher values for all scoring systems correlated with greater reliability and greater popularity, respectively. Five hundred videos were screened. Two hundred thirty-four videos were duplicates, and 99 did not meet the inclusion criteria. A total of 167 videos were reviewed. The median VPI and MQ-VET score was 201,114.76 (interquartile range, 7,194,020.29) and 48.00 (interquartile range, 12.75), respectively. Spearman's R value was 0.292 (P < 0.001), demonstrating a weak positive correlation between MQ-VET scores and VPI. The interrater reliability of the MQ-VET was good, with an intraclass correlation coefficient of 0.86 (95% confidence interval, 0.71-0.92). In summary, we identified a statistically significant but weak positive correlation between the reliability and popularity of YouTube videos about pelvic floor physical therapy.

DOI: https://doi.org/10.1097/SPV.0000000000001456
Cureus. 2024 Mar;16(3): e55891

Assessing the Quality and Clarity of YouTube Videos as an Informational Source for Ankle Fractures: A Study of the Turkish Population.

Yaşar Samet Gökçeoğlu, Ayşe Nur İncesu, Elif Eda Dağ, Elif Yağmur Özger, Turgut Akgül.

  Background and objective The significance of YouTube as a prominent source of healthcare-related information cannot be overstated. Its influence on patient education is substantial. However, despite its popularity, there has been little research into the quality and comprehensibility of videos related to ankle fractures, a condition with increasing incidence rates, particularly in the context of Turkey. To address this gap in the literature and the growing reliance on digital platforms for health information during the coronavirus disease 2019 (COVID-19) pandemic, this study aims to assess the quality, clarity, and pedagogical value of YouTube videos on ankle fractures for the Turkish population. Methodology A comprehensive examination of 150 YouTube videos concerning ankle fractures, employing exacting inclusion and exclusion criteria to identify 52 videos for in-depth analysis was undertaken. The investigation entailed an assessment of content quality, presentation style, and user interaction, utilizing the criteria established by the Journal of the American Medical Association (JAMA) and the Patient Education Materials Assessment Tool (PEMAT), as well as a novel measurement known as the Ankle Fracture Content Score (AFCS). A statistical analysis was executed to gauge the educational value and dependability of the information presented. Results The majority of ankle fracture management videos were found to be uploaded by medical professionals, covering various aspects such as rehabilitation and patient testimonials. However, the overall educational quality was suboptimal, with patient-shared videos lacking in depth and accuracy. Statistical analysis showed no significant differences in content quality across different uploader categories, except for notably lower educational quality in videos shared by patients. Conclusions The findings underscore a significant need for healthcare professionals and academic institutions in Turkey to produce and share high-quality, reliable, and comprehensible videos on ankle fractures. Leveraging YouTube's extensive reach can significantly improve health literacy among the Turkish public, ensuring access to accurate and trustworthy health information.

Keywords:  ankle fracture; health education; informatics; information literacy; information quality; medicine; video sharing

DOI:  https://doi.org/10.7759/cureus.55891
Knee Surg Sports Traumatol Arthrosc. 2024 Mar 15.

Information videos posted on Instagram by orthopaedics and sports traumatology surgeons mostly explain surgical technique, and the least mentioned topics are injury prevention and complications.

Yavuz Şahbat, Barış Kocaoğlu, Matthieu Ollivier, Simone Cerciello, Doruk Akgün, Eduard Alentorn-Geli, Mahmut Enes Kayaalp, Hasan Furkan Akın, Poroshista Knauer, Abdulaziz Hariri, Fabrizio Mocini, Aleix Pons Bartroli, Romain Seil.

   PURPOSE: Social media has become the new information acquisition platform for all content producers. In the current literature, there are no studies examining the content quality and the strengths and weaknesses of videos on Instagram that explain anterior cruciate ligament (ACL) injuries, which is the most discussed topic of sports surgery. The aim of this study was to evaluate the quality, strengths and weaknesses of information pertaining to ACL surgery that is disseminated on Instagram.
METHOD: An Instagram search was conducted from 30 May 2023 to 30 January 2024. The search encompassed six languages (English, Spanish, German, French, Italian and Turkish) and was performed by six different observers. The investigation focused on eight subheadings derived from current literature on the ACL. These subheadings were addressed in Instagram videos, covering ACL biology or biomechanics, injury mechanism, injury prevention, injury evaluation, surgical technique, injury or surgery complications, injury rehabilitation process and return to sport or work.
RESULT: The content was assessed of 127 videos from 127 Instagram accounts, spanning six different languages. Across the review of eight subheadings, the average number covered for the entire group was 3 (range, 0-8). Further analysis revealed that surgical technique was the most frequently mentioned subheading for the whole group (68.5%), followed by injury evaluation (54.3%). Prevention (10.2%) and complications (19.6%) were the least mentioned subheadings. The number of followers showed a correlation with video content quality.
CONCLUSION: Although the video quality scores were found to be moderate, the content often focused on surgery and evaluation subheadings. The prevalence of incomplete information underscores the importance of developing strategies to ensure more comprehensive and accurate dissemination of medical knowledge.
LEVEL OF EVIDENCE: Level V.

Keywords:  anterior cruciate ligament; knee Injury; mobile social media; sources of information

DOI:  https://doi.org/10.1002/ksa.12140
J Med Internet Res. 2024 Mar 11. 26 e48977

Online Health Information Seeking and Preventative Health Actions: Cross-Generational Online Survey Study.

Jayati Sinha, Nuket Serin.

   BACKGROUND: The popularity of online health information seeking (OHIS) has increased significantly owing to its accessibility and affordability. To facilitate better health management, it is essential to comprehend the generational differences in OHIS behavior and preventative health actions after seeking online health information (OHI).
OBJECTIVE: This study investigates the variations in OHIS and engagement in preventative health actions between 2 generations based on their technology use (digital natives [aged 18-42 years] and digital immigrants [aged ≥43 years]). Additionally, this research explores the mediating role of OHIS types on the generational effect on preventative health actions and the moderating role of OHI search frequency, gender, and the presence of chronic diseases on the generational effect on OHIS types and preventative health actions.
METHODS: A preregistered online survey was conducted on the Prolific online data collection platform using stratified sampling of 2 generations (digital natives and digital immigrants) from the United States in November 2023. Overall, 3 types of OHIS were collected: health wellness information search, health guidance information search, and health management information search. A 1-way analysis of covariance tested the generational differences in types of OHIS and preventative health actions, and a 2-way analysis of covariance tested the moderating role of OHIS search frequency, gender, and the presence of chronic diseases using 7 control variables. The PROCESS Macro Model 4 was used to conduct mediation analyses, testing OHI search types as mediators. Linear regression analyses tested age as a predictor of OHIS and preventative health actions.
RESULTS: The analysis of 1137 responses revealed generational differences in OHIS. Digital natives searched for health wellness information more frequently (P<.001), whereas digital immigrants searched for health guidance (P<.001) and health management information (P=.001) more frequently. There were no significant differences between the 2 generations regarding preventative health actions (P=.85). Moreover, all 3 types of OHIS mediated the relationship between generational differences and preventative health actions. Furthermore, as people aged, they searched for significantly less health wellness information (P<.001) and more health guidance (P<.001), and health management information (P=.003). Age was not a significant predictor of preventative health actions (P=.48). The frequency of OHI searches did not moderate the effect of generations on OHIS types and preventative health actions. Gender only moderated the relationship between generation and health guidance information search (P=.02), and chronic diseases only moderated the relationship between generation and health wellness information search (P=.03).
CONCLUSIONS: To the best of our knowledge, this study is the first to explore how 2 digital generations vary in terms of searching for OHI and preventative health behaviors. As the older adult population grows, it is crucial to understand their OHIS behavior and how they engage in preventative health actions to enhance their quality of life.

Keywords:  digital immigrants; digital natives; mobile phone; online health information seeking; preventative health actions

DOI:  https://doi.org/10.2196/48977
J Educ Health Promot. 2023 ;12 432

Health information-seeking behavior of nursing students in Isfahan city about COVID-19 disease.

Amir Musarezaie, Hasan Ashrafi-Rizi, Nasrin Musarezaie, Tahere Momeni-Ghale Ghasemi.

   BACKGROUND: The proper planning to help the health information-seeking behavior (HISB), as well as promoting its quantitative and qualitative level among nursing students increases educational efficiency and enables provide appropriate services to patients. The purpose of this study is to investigate the HISB of nursing students in the process of obtaining information about the emerging disease of COVID-19 in Isfahan city.
MATERIALS AND METHOD: The present cross-sectional descriptive-analytical study was conducted in Isfahan´ s faculties of nursing and educational hospitals. The research sample included 448 students who met the inclusion criteria, using convenience sampling. Lenz's HISB questionnaire was used to collect information. Data were analyzed using Statistical Package for the Social Sciences statistical software version 20, using descriptive and inferential statistics, with confidence interval = 95%.
RESULTS: The results indicate a statistically significant relationship between the age and marital status of students with the overall score of the HISB of nursing students (P < 0.05). Regarding the study, information was mostly obtained from "social media" (43.7%) although the participants more trusted in "health experts" (57.5%). The results of the present study indicated that the students often searched for "disease symptoms" (38.8%) and "epidemiological issues" (22.5%).
DISCUSSION: "Internet sites and search engines" and "social media" provide quick access to information for users, which is one of the reasons for favoring these sources. However, they can be a platform for disseminating false and invalid information. Thus, other reliable sources such as the Ministry of Health and Medical Education should play a greater role in creating content on social media.

Keywords:  COVID-19; Iran; health information-seeking behavior; nursing students

DOI:  https://doi.org/10.4103/jehp.jehp_1700_22
Breastfeed Med. 2024 Mar 15.

Information Seeking Behavior and Strategies to Increase Milk Supply Among Breastfeeding Mothers in the United States.

Rachel A Ryan, Jessica Dauz Bihuniak, Audrey Lyndon, Allison Doub Hepworth.

  Background: Some breastfeeding mothers try to increase their milk supply through pharmaceutical, dietary, and behavioral strategies that vary in effectiveness. Information seeking behaviors may influence which strategies mothers use. Objective: To describe where mothers obtain information about increasing milk supply, describe the perceived influence of each information source on decision-making about strategies for increasing milk supply, and explore associations between information sources and mothers' use of galactagogues (i.e., pharmaceutical and dietary strategies) and behavioral strategies. Methods: Women who were currently breastfeeding and living in the United States were recruited through Facebook advertisements to complete an online survey between December 2020 and February 2021. Descriptive statistics were calculated, and chi-square tests compared participants' use of galactagogues and behavioral strategies by information sources. Results: Participants were 1,351 breastfeeding mothers (81% non-Hispanic white; 47% first-time breastfeeding; 21% Special Supplemental Nutrition Program for Women, Infants, and Children participants). Nearly all participants (97%) obtained information about increasing milk supply from at least one source, most commonly lactation consultants (68%), Facebook (61%), search engines (50%), websites (47%), and nurses (41%). There was high variability in the perceived influence of each source on decision-making. Galactagogue use was higher among participants who obtained information from the internet (Yes: 68% vs. No: 43%, p < 0.000), social media (Yes: 65% vs. No: 40%, p < 0.000), family and friends (Yes: 65% vs. No: 53%, p < 0.000), and lactation consultants (Yes: 63% vs. No: 54%, p < 0.002). Behavioral strategies were more commonly reported among participants who accessed these same sources, maternal health care professionals (Yes: 98% vs. No: 91%, p < 0.000), and pediatricians (Yes: 98% vs. No: 94%, p = 0.001). Conclusion: Breastfeeding mothers commonly obtained information about increasing milk supply from a variety of sources. Information sources accessed were associated with mothers' use of galactagogues and behavioral strategies for increasing milk supply.

Keywords:  breastfeeding; galactagogues; information seeking behavior; lactation; perceived insufficient milk

DOI:  https://doi.org/10.1089/bfm.2024.0006
Nurs Open. 2024 Mar;11(3): e2140

Health information sources and health-seeking behaviours of Filipinos living in medically underserved communities: Empirical quantitative research.

Jennifer Kawi, Miguel Fudolig, Reimund Serafica, Andrew T Reyes, Francisco Sy, Erwin William A Leyva, Lorraine S Evangelista.

   AIMS: To describe sources of health information and health-seeking behaviours of adults (aged ≥18) living in medically underserved communities in the Philippines.
DESIGN: This is a secondary, quantitative analysis from a cross-sectional parent study. Participants completed a 10-item, self-report survey on their sources of health information, healthcare providers sought for health and wellness and health-seeking behaviours when ill. Responses were evaluated across two age groups (<60 vs. ≥60 years) and genders using generalized linear mixed models.
RESULTS: Surveys were completed by 1202 participants in rural settings (64.6% female, mean age 49.5 ± 17.6). Friends and/or family were their key source of health information (59.6%), followed by traditional media (37%) and healthcare professionals (12.2%). For health promotion, participants went to healthcare professionals (60.9%), informal healthcare providers (17.2%) or others (7.2%). When ill, they visited a healthcare professional 69.1% of the time, self-medicated (43.9%), prayed (39.5%) or sought treatment from a rural health clinic (31.5%). We also found differences in health-seeking behaviours based on age and gender.
CONCLUSIONS: Our findings highlight the need to organize programs that explicitly deliver accurate health information and adequate care for wellness and illness. Study findings emphasize the importance of integrating family, friends, media and healthcare professionals, including public health nurses, to deliver evidence-based health information, health promotion and sufficient treatment to medically underserved Filipinos.
IMPLICATIONS: New knowledge provides valuable information to healthcare providers, including public health nurses, in addressing health disparities among medically underserved Filipinos.
IMPACT: This study addresses the current knowledge gap in a medically vulnerable population. Healthcare professionals are not the primary sources of health information. Approximately one-third of participants do not seek them for health promotion or treatment even when ill, exacerbating health inequities. More work is necessary to support initiatives in low- and middle-income countries such as the Philippines to reduce health disparities.
REPORTING METHOD: We adhered to the reporting guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) for cross-sectional studies.
PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution as our study design and methodology do not make this necessary.

Keywords:  Filipinos; health behaviours; health disparities; health information; health promotion; low- and middle-income countries; underserved

DOI:  https://doi.org/10.1002/nop2.2140