Antigenic Fingerprinting of H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies Reveals Potential Vaccine and Diagnostic Targets

Using whole-genome-fragment phage display libraries, Hana Golding and colleagues identify the viral epitopes recognized by serum antibodies in humans who have recovered from infection with H5N1 avian influenza

FROM ONLINE ENGAGEMENT TO OFFLINE ACTIONS: UNDERSTANDING THE IMPACT OF CANCER (MIS)INFORMATION ENGAGEMENT AMONG LATINO FACEBOOK USERS

Latinos in the U.S. face a high burden of cancer, making it important to deliver evidence-based cancer prevention and screening information (CPSI) on social media to this group. However, there is a dearth in scholarship exploring how Latinos engage with and act upon cancer (mis)information encountered on social media. Cultural values may influence how Latinos engage with multi-lingual CPSI shared on Facebook. This study sought to understand how and why U.S. Latinos engage with and act upon CPSI on Facebook. During one-on-one, in-depth interviews, participants (n=20) logged onto their Facebook account alongside the researcher, typed “cancer” in the search bar, and discussed CPSI they engaged with during the past 12 months. Engagement prompted questions regarding the reasons for engagement and further action. Computer screen and audio were recorded. Interviews were analyzed thematically; CPSI was analyzed via content analysis. Participants mainly engaged with CPSI by viewing/reading content. Engagement was most common when individuals had personal relationships to the poster, when posts included videos/images, and when information promoted popular Latin American foods. Engagement often led to varying levels of action, both online and offline. Not all decisions were evidence-based, and some were potentially harmful (e.g. canceling mammogram after engaging with misinformation). Findings highlight the complex and interrelated ways in which cultural values, source factors and message factors contribute to engagement with health content on social media, which may lead individuals to bypass evidence-based procedures in favor of unproven approaches. Specific interdisciplinary recommendations to address these issues will be discussed

EXPLORING CANCER PREVENTION AND SCREENING INFORMATION ENGAGEMENT ON FACEBOOK AMONG U.S. LATINOS

Latinos, the largest minority in the U.S., face a high burden of cancer, making it important to deliver evidence-based cancer prevention and screening information (CPSI) to them. Social media presents an innovative platform to engage with Latinos dialogically by allowing user interaction through posts, pictures, videos, and other information sharing. Due to its popularity, Facebook is a useful platform for Latinos without a history of cancer to engage with CPSI. This is particularly important among Latinos age 40-75, as they are eligible for breast, prostate, and/or colorectal cancer screenings. However, there is a dearth in scholarship exploring how Latinos engage with and act upon content encountered on social media, which may be influenced by cultural values. This qualitatively-driven, mixed methods dissertation explored how U.S. Latinos engage with, assess the credibility of, and act upon CPSI on Facebook. During one-on-one, in-person encounters, participants (n=20) accessed their Facebook profiles and discussed engagement with cancer-related posts with the researcher. Engagement with content prompted semi-structured, in-depth interviews discussing reasons for engagement, credibility assessments, and subsequent actions. Data were analyzed via content analysis and thematic analysis. Results demonstrate that cultural values and other cultural connectors (e.g., language and country of origin) play a salient role in how message factors and source factors influence the way Latinos engage with and assess the credibility of CPSI. Furthermore, both engagement and credibility assessments – as influenced by culture – appear to impact how some Latinos choose to act upon CPSI, both online and offline. Actions taken were sometimes informed by inaccurate credibility assessments, which may lead to potentially harmful outcomes. Findings provide important methodological, theoretical, and practical contributions to a growing area of public health research that is interested in curtailing the effects of misinformation on health outcomes

IMAGES OF POST-MASTECTOMY SCARRING ON INSTAGRAM: AN EVALUATION OF CONTENT MODERATION AND THE IMPLICATIONS FOR PUBLIC HEALTH

This paper presents the results of a pilot study examining the moderation of images depicting post-mastectomy scaring on Instagram by skin tone darkness and the presence or absence of tattoos. It focuses on Instagram given widespread concerns that images of women’s bodies are arbitrarily moderated on the platform, and on depictions of post-mastectomy scarring, one of few explicitly allowed categories of content on Instagram, because mastectomies have important ramifications for women’s self-image and identity worldwide. After using an input/output method of black box analytics, in conjunction with content analysis, preliminary data show potential false positives (n = 31/74 images). While these results are not statistically significant, there is a strong argument for further in-depth investigation as there appears to be differences in removal rates by presence of tattoos and by skin tone darkness. Specifically, a logistic regression suggests that the odds of an image being removed increase by a factor of 1.21 for every unit increase in skin tone darkness. Potential arbitrariness is concerning in this context for many reasons, including that content takedowns can have negative effects on the well-being of women seeking to share their experiences with, or learn from the experiences of, others who have undergone mastectomies. This research ultimately aims to make valuable contributions to the growing body of literature on the moderation of female forms on Instagram and contribute to ongoing debates around the transparency and accountability of platform governance more broadly

“WHY WOULD SOMEONE INTENTIONALLY LIE?”: ASSESSING THE CREDIBILITY OF CANCER (MIS)INFORMATION ON FACEBOOK

As misinformation on social media continues to proliferate, scholars are increasingly calling for explorations of the negative ramifications of health-related misinformation on health outcomes. In 2018, 96% of the top 100 shared health articles were shared on Facebook; 51% of these had neutral to poor credibility. This exploratory study seeks to understand how U.S. Latinos assess the credibility of the cancer screening and prevention information (CPSI) they engage with on Facebook. Through semi-structured in-depth interviews, participants (n=20) accessed their Facebook account alongside the researcher, typed “cancer” in the search bar, and discussed cancer-related posts they engaged with during the past 6-12 months. If a participant engaged with CPSI, the researcher asked questions regarding if and how participants assessed the credibility of the information. Computer screen and audio were recorded for analysis. Interviews are being analyzed thematically, and CPSI via content analysis. Preliminary findings suggest most CPSI engagement comes from Facebook Friends and Groups that at times share unreliable information (e.g. foods claiming cancer prevention/curative properties). Participants with higher education levels were more likely to verify information via outside sources, while others looked for cues within the post to assess credibility (i.e. being shared by a reputable news agency). However, most individuals rely on heuristics (post virality, cultural associations, testimonies) to assess information credibility, rather than a verification process. These findings can assist in developing social media campaigns to counteract health misinformation. Findings also raise broader questions regarding Facebook’s role/responsibility in regulating and monitoring its platform’s health misinformation

Accurate and Inaccurate Beliefs about Cancer Risk Factors among Spanish-Speaking Adults in the United States

Objective: To characterize inaccurate and accurate beliefs about cancer risk factors held among Spanish-speaking adults in the United States. Methods: From a national probability panel, we surveyed 196 Hispanic adults who prefer completing questionnaires in Spanish. We also used data from a representative sample of 1,200 adults in the US to compare belief acceptance. Results: Many less accepted accurate beliefs about cancer risk factors related to topics like fruit/vegetable consumption, weight loss, and alcohol use. Several inaccurate beliefs were widely held, with some being more accepted in the Spanish-speaking sample than the general US adult sample. Higher levels of self-reported media literacy and information scanning associated with more acceptance of both accurate and inaccurate beliefs. Access to the internet at home associated with discernment between accurate and inaccurate beliefs about cancer risk factors. Conclusion: Acceptance of accurate beliefs and rejection of inaccurate beliefs varied across potential cancer risk factors. Future Spanish-language public health messaging should address these belief inconsistencies when providing up-to-date cancer-related recommendations or correcting inaccurate information in the public communication environment. Innovation: Our study provides novel information about cancer risk factor beliefs that may be more subject to misinformation, confusion, and uncertainty in an understudied population

Making a picture worth a thousand numbers: recommendations for graphically displaying patient-reported outcomes data

Purpose: Patient-reported outcomes (PROs) can promote patient-centered care in multiple ways: (1) using an individual patient’s PRO data to inform his/her management, (2) providing PRO results from comparative research studies in patient educational materials/decision aids, and (3) reporting PRO results from comparative research studies in peer-reviewed publications. Patients and clinicians endorse the value of PRO data; however, variations in how PRO measures are scored and scaled, and in how the data are reported, make interpretation challenging and limit their use in clinical practice. We conducted a modified Delphi process to develop stakeholder-engaged, evidence-based recommendations for PRO data display for the three above applications to promote understanding and use. Methods: The Consensus Panel included cancer survivors/caregivers, oncologists, PRO researchers, and application-specific end-users (e.g., electronic health record vendors, decision aid developers, journal editors). We reviewed the data display issues and their evidence base during pre-meeting webinars. We then surveyed participants’ initial perspectives, which informed discussions during an in-person meeting to develop consensus statements. These statements were ratified via a post-meeting survey. Results: Issues addressed by consensus statements relevant to both individual and research data applications were directionality (whether higher scores are better/worse) and conveying score meaning (e.g., none/mild/moderate/severe). Issues specific to individual patient data presentation included representation (bar charts vs. line graphs) and highlighting possibly concerning scores (absolute and change). Issues specific to research study results presentation included handling normed data, conveying statistically significant differences, illustrating clinically important differences, and displaying proportions improved/stable/worsened. Conclusions: The recommendations aim to optimize accurate and meaningful interpretation of PRO data