Background: Infectious disease surveillance is difficult in many low- and middle-income countries. Information market (IM)-based participatory surveillance is a crowdsourcing method that encourages individuals to actively report health symptoms and observed trends by trading web-based virtual "stocks" with payoffs tied to a future event.
Objective: This study aims to assess the feasibility and acceptability of a tailored IM surveillance system to monitor population-level COVID-19 outcomes in Accra, Ghana.
Methods: We designed and evaluated a prediction markets IM system from October to December 2021 using a mixed methods study approach. Health care workers and community volunteers aged ≥18 years living in Accra participated in the pilot trading. Participants received 10,000 virtual credits to trade on 12 questions on COVID-19-related outcomes. Payoffs were tied to the cost estimation of new and cumulative cases in the region (Greater Accra) and nationwide (Ghana) at specified future time points. Questions included the number of new COVID-19 cases, the number of people likely to get the COVID-19 vaccination, and the total number of COVID-19 cases in Ghana by the end of the year. Phone credits were awarded based on the tally of virtual credits left and the participant's percentile ranking. Data collected included age, occupation, and trading frequency. In-depth interviews explored the reasons and factors associated with participants' user journey experience, barriers to system use, and willingness to use IM systems in the future. Trading frequency was assessed using trend analysis, and ordinary least squares regression analysis was conducted to determine the factors associated with trading at least once.
Results: Of the 105 eligible participants invited, 21 (84%) traded at least once on the platform. Questions estimating the national-level number of COVID-19 cases received 13 to 19 trades, and obtaining COVID-19-related information mainly from television and radio was associated with less likelihood of trading (marginal effect: -0.184). Individuals aged <30 years traded 7.5 times more and earned GH ¢134.1 (US $11.7) more in rewards than those aged >30 years (marginal effect: 0.0135). Implementing the IM surveillance was feasible; all 21 participants who traded found using IM for COVID-19 surveillance acceptable. Active trading by friends with communal discussion and a strong onboarding process facilitated participation. The lack of bidirectional communication on social media and technical difficulties were key barriers.
Conclusions: Using an IM system for disease surveillance is feasible and acceptable in Ghana. This approach shows promise as a cost-effective source of information on disease trends in low- and middle-income countries where surveillance is underdeveloped, but further studies are needed to optimize its use.
Background: TikTok (ByteDance) experienced a surge in popularity during the COVID-19 pandemic as a way for people to interact with others, share experiences and thoughts related to the pandemic, and cope with ongoing mental health challenges. However, few studies have explored how youth use TikTok to learn about mental health.
Objective: This study aims to understand how youth used TikTok during the COVID-19 pandemic to learn about mental health and mental health support.
Methods: Semistructured interviews were conducted with 21 youths (aged 12-24 years) living in British Columbia, Canada, who had accessed TikTok for mental health information during the COVID-19 pandemic. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed using an inductive, data-driven approach.
Results: A total of 3 overarching themes were identified describing youth's experiences. The first theme centered on how TikTok gave youth easy access to mental health information and support, which was particularly helpful during the COVID-19 pandemic to curb the effects of social isolation and the additional challenges of accessing mental health services. The second theme described how the platform provided youth with connection, as it gave youth a safe space to talk about mental health and allowed them to feel seen by others going through similar experiences. This helped normalize and destigmatize conversations about mental health and brought awareness to various mental health conditions. Finally, the last theme focused on how this information led to action, such as trying different coping strategies, discussing mental health with peers and family, accessing mental health services, and advocating for themselves during medical appointments. Across the 3 themes, youth expressed having to be mindful of bias and misinformation, highlighting the barriers to identifying and reporting misinformation and providing individualized advice on the platform.
Conclusions: Findings suggest that TikTok can be a useful tool to increase mental health awareness, reduce stigma, and encourage youth to learn and address their mental health challenges while providing a source of peer connection and support. Simultaneously, TikTok can adversely impact mental health through repetitive exposure to mentally distressing content and misleading diagnosis and treatment information. Regulations against harmful content are needed to mitigate these risks and make TikTok safer for youth. Efforts should also be made to increase media and health literacy among youth so that they can better assess the information they consume online.
Background: Prenatal alcohol exposure represents a substantial public health concern as it may lead to detrimental outcomes, including pregnancy complications and fetal alcohol spectrum disorder. Although UK national guidance recommends abstaining from alcohol if pregnant or planning a pregnancy, evidence suggests that confusion remains on this topic among members of the public, and little is known about what questions people have about consumption of alcohol in pregnancy outside of health care settings.
Objective: This study aims to assess what questions and topics are raised on alcohol in pregnancy on a web-based UK-based parenting forum and how these correspond to official public health guidelines with respect to 2 critical events: the implementation of the revised UK Chief Medical Officers' (CMO) low-risk drinking guidelines (2016) and the first COVID-19 pandemic lockdown (2020).
Methods: All thread starts mentioning alcohol in the "Pregnancy" forum were collected from Mumsnet for the period 2002 to 2022 and analyzed using qualitative content analysis. Descriptive statistics were used to characterize the number and proportion of thread starts for each topic over the whole study period and for the periods corresponding to the change in CMO guidance and the COVID-19 pandemic.
Results: A total of 395 thread starts were analyzed, and key topics included "Asking for advice on whether it is safe to consume alcohol" or on "safe limits" and concerns about having consumed alcohol before being aware of a pregnancy. In addition, the Mumsnet thread starts included discussions and information seeking on "Research, guidelines, and official information about alcohol in pregnancy." Topics discussed on Mumsnet regarding alcohol in pregnancy remained broadly similar between 2002 and 2022, although thread starts disclosing prenatal alcohol use were more common before the introduction of the revised CMO guidance than in later periods.
Conclusions: Web-based discussions within a UK parenting forum indicated that users were often unclear on guidance and risks associated with prenatal alcohol use and that they used this platform to seek information and reassurance from peers.
Background: TikTok is one of the most-used and fastest-growing social media platforms in the world, and recent reports indicate that it has become an increasingly popular source of news and information in the United States. These trends have important implications for public health because an abundance of health information exists on the platform. Women are among the largest group of TikTok users in the United States and may be especially affected by the dissemination of health information on TikTok. Prior research has shown that women are not only more likely to look for information on the internet but are also more likely to have their health-related behaviors and perceptions affected by their involvement with social media.
Objective: We conducted a survey of young women in the United States to better understand their use of TikTok for health information as well as their perceptions of TikTok's health information and health communication sources.
Methods: A web-based survey of US women aged 18 to 29 years (N=1172) was conducted in April-May 2023. The sample was recruited from a Qualtrics research panel and 2 public universities in the United States.
Results: The results indicate that the majority of young women in the United States who have used TikTok have obtained health information from the platform either intentionally (672/1026, 65.5%) or unintentionally (948/1026, 92.4%). Age (959/1026, 93.47%; r=0.30; P<.001), education (959/1026, 93.47%; ρ=0.10; P=.001), and TikTok intensity (ie, participants' emotional connectedness to TikTok and TikTok's integration into their daily lives; 959/1026, 93.47%; r=0.32; P<.001) were positively correlated with overall credibility perceptions of the health information. Nearly the entire sample reported that they think that misinformation is prevalent on TikTok to at least some extent (1007/1026, 98.15%), but a third-person effect was found because the young women reported that they believe that other people are more susceptible to health misinformation on TikTok than they personally are (t1025=21.16; P<.001). Both health professionals and general users were common sources of health information on TikTok: 93.08% (955/1026) of the participants indicated that they had obtained health information from a health professional, and 93.86% (963/1026) indicated that they had obtained health information from a general user. The respondents showed greater preference for health information from health professionals (vs general users; t1025=23.75; P<.001); the respondents also reported obtaining health information from health professionals more often than from general users (t1025=8.13; P<.001), and they were more likely to act on health information from health professionals (vs general users; t1025=12.74; P<.001).
Conclusions: The findings suggest that health professi
Background: Attitudes toward the human papillomavirus (HPV) vaccine and accuracy of information shared about this topic in web-based settings vary widely. As real-time, global exposure to web-based discourse about HPV immunization shapes the attitudes of people toward vaccination, the spread of misinformation and misrepresentation of scientific knowledge contribute to vaccine hesitancy.
Objective: In this study, we aimed to better understand the type and quality of scientific research shared on Twitter (recently rebranded as X) by vaccine-hesitant and vaccine-confident communities.
Methods: To analyze the use of scientific research on social media, we collected tweets and retweets using a list of keywords associated with HPV and HPV vaccines using the Academic Research Product Track application programming interface from January 2019 to May 2021. From this data set, we identified tweets referring to or sharing scientific literature through a Boolean search for any tweets with embedded links, hashtags, or keywords associated with scientific papers. First, we used social network analysis to build a retweet or reply network to identify the clusters of users belonging to either the vaccine-confident or vaccine-hesitant communities. Second, we thematically assessed all shared papers based on typology of evidence. Finally, we compared the quality of research evidence and bibliometrics between the shared papers in the vaccine-confident and vaccine-hesitant communities.
Results: We extracted 250 unique scientific papers (including peer-reviewed papers, preprints, and gray literature) from approximately 1 million English-language tweets. Social network maps were generated for the vaccine-confident and vaccine-hesitant communities sharing scientific research on Twitter. Vaccine-hesitant communities share fewer scientific papers; yet, these are more broadly disseminated despite being published in less prestigious journals compared to those shared by the vaccine-confident community.
Conclusions: Vaccine-hesitant communities have adopted communication tools traditionally wielded by health promotion communities. Vaccine-confident communities would benefit from a more cohesive communication strategy to communicate their messages more widely and effectively.
Background: Abortion (also known as termination of pregnancy) is an essential element of women's reproductive health care. Feedback from women who underwent medical termination of pregnancy about their experience is crucial to help practitioners identify women's needs and develop necessary tools to improve the abortion care process. However, the collection of this feedback is quite challenging. Social media offer anonymity for women who share their abortion experience.
Objective: This exploratory infodemiology study aimed to analyze, through French social media posts, personal medical symptoms and the different experiences and information dynamics associated with the medical abortion process.
Methods: A retrospective study was performed by analyzing posts geolocated in France and published from January 1, 2017, to November 30, 2021. Posts were extracted from all French-language general and specialized publicly available web forums using specific keywords. Extracted messages were cleaned and pseudonymized. Automatic natural language processing methods were used to identify posts from women having experienced medical abortion. Biterm topic modeling was used to identify the main discussion themes and the Medical Dictionary for Regulatory Activities was used to identify medical terms. Encountered difficulties were explored using qualitative research methods until the saturation of concepts was reached.
Results: Analysis of 5398 identified posts (3409 users) led to the identification of 9 major topics: personal experience (n=2413 posts, 44.7%), community support (n=1058, 19.6%), pain and bleeding (n=797, 14.8%), psychological experience (n=760, 14.1%), questioned efficacy (n=410, 7.6%), social pressure (n=373, 6.9%), positive experiences (n=257, 4.8%), menstrual cycle disorders (n=107, 2%), and reported inefficacy (n=104, 1.9%). Pain, which was mentioned in 1627 (30.1%) of the 5398 posts by 1024 (30.0%) of the 3409 users, was the most frequently reported medical term. Pain was considered severe to unbearable in 24.5% of the cases (399 of the 1627 posts). Lack of information was the most frequently reported difficulty during and after the process.
Conclusions: Our findings suggest that French women used social media to share their experiences, offer and find support, and provide and receive information regarding medical abortion. Infodemiology appears to be a useful tool to obtain women's feedback, therefore offering the opportunity to enhance care in women undergoing medical abortion.
Background: Health misinformation on social media can negatively affect knowledge, attitudes, and behaviors, undermining clinical care and public health efforts. Therefore, it is vital to better understand the public's experience with health misinformation on social media.
Objective: The goal of this analysis was to examine perceptions of the social media information environment and identify associations between health misinformation perceptions and health communication behaviors among US adults.
Methods: Analyses used data from the 2022 Health Information National Trends Survey (N=6252). Weighted unadjusted proportions described respondents' perceptions of the amount of false or misleading health information on social media ("perceived misinformation amount") and how difficult it is to discern true from false information on social media ("perceived discernment difficulty"). Weighted multivariable logistic regressions examined (1) associations of sociodemographic characteristics and subjective literacy measures with misinformation perceptions and (2) relationships between misinformation perceptions and health communication behaviors (ie, sharing personal or general health information on social media and using social media information in health decisions or in discussions with health care providers).
Results: Over one-third of social media users (35.61%) perceived high levels of health misinformation, and approximately two-thirds (66.56%) reported high perceived discernment difficulty. Odds of perceiving high amounts of misinformation were lower among non-Hispanic Black/African American (adjusted odds ratio [aOR] 0.407, 95% CI 0.282-0.587) and Hispanic (aOR 0.610, 95% CI 0.449-0.831) individuals compared to White individuals. Those with lower subjective health literacy were less likely to report high perceived misinformation amount (aOR 0.602, 95% CI 0.374-0.970), whereas those with lower subjective digital literacy were more likely to report high perceived misinformation amount (aOR 1.775, 95% CI 1.400-2.251). Compared to White individuals, Hispanic individuals had lower odds of reporting high discernment difficulty (aOR 0.620, 95% CI 0.462-0.831). Those with lower subjective digital literacy (aOR 1.873, 95% CI 1.478-2.374) or numeracy (aOR 1.465, 95% CI 1.047-2.049) were more likely to report high discernment difficulty. High perceived misinformation amount was associated with lower odds of sharing general health information on social media (aOR 0.742, 95% CI 0.568-0.968), using social media information to make health decisions (aOR 0.273, 95% CI 0.156-0.479), and using social media information in discussions with health care providers (aOR 0.460, 95% CI 0.323-0.655). High perceived discernment difficulty was associated with higher odds of using social media information in health decisions (aOR 1.724, 95% CI 1.208-2.460) and health care provider discussions
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