It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook

Background: Due in part to declining vaccination rates, in 2018 over 20 states reported at least one case of measles, and over 40,000 cases have been confirmed in Europe. Anti-vaccine posts on social media may be facilitating anti-vaccination behaviour. This study aimed to systematically characterize (1) individuals known to publicly post anti-vaccination content on Facebook, (2) the information they convey, and (3) the spread of this content. Methods: Our data set consisted of 197 individuals who posted anti-vaccination comments in response to a message promoting vaccination. We systematically analysed publicly-available content using quantitative coding, descriptive analysis, social network analysis, and an in-depth qualitative assessment. The final codebook consisted of 26 codes; Cohen’s κ ranged 0.71-1.0 after double-coding. Results: The majority (89%) of individuals identified as female. Among 136 individuals who divulged their location, 36 states and 8 other countries were represented. In a 2-mode network of individuals and topics, modularity analysis revealed 4 distinct sub-groups labelled as “trust,” “alternatives,” “safety,” and “conspiracy.” For example, a comment representative of “conspiracy” is that poliovirus does not exist and that pesticides caused clinical symptoms of polio. An example from the “alternatives” sub-group is that eating yogurt cures human papillomavirus. Deeper qualitative analysis of all 197 individuals’ profiles found that these individuals also tended to post material against other health-related practices such as water fluoridation and circumcision. Conclusions: Social media outlets may facilitate anti-vaccination connections and organization by facilitating the diffusion of centuries old arguments and techniques. Arguments against vaccination are diverse but remain consistent within sub-groups of individuals. It would be valuable for health professionals to leverage social networks to deliver more effective, targeted messages to different constituencies

Direct Long-acting Antibodies: Updating the Language of RSV Prevention to Reflect the Evolution of mAbs

Background: The language of medicine is constantly evolving, typically to better describe a new understanding of disease, adjust to changing social sensibilities, or simply to reflect a new drug class or category. We address the need for an updated language around monoclonal antibodies, or “mAbs”—a widely used medical term, but one which is now too general to accurately reflect the range of mAb pharmaceuticals, their effects, and the intended patients. Methods: The question of “what should we call a monoclonal antibody immunisation against respiratory syncytial virus (RSV) to ensure accurate understanding of the product?” was the basis for a virtual advisory panel in May 2022. The panel was convened by Sanofi with the intention of reviewing appropriate language in terminology in the context of mAb-based prophylaxis for RSV. The panel comprised several global experts on RSV and vaccination, a trained linguist specializing in doctor-patient interactions and medical language, and several experts in marketing and communications. Results: We suggest the term “Direct Long-acting Antibody” (DLA) for a specific sub-class of mAbs for use in prevention of RSV disease in infants. This terminology should differentiate from other mAbs, which are generally not used as therapies in infants. Conclusions: This change will more accurately convey the specific mode of action of a mAb in infants, and how it could impact the prevention of communicable diseases: this class of mAbs is not an active treatment, but rather will offer direct and rapid protection lasting at least 5 months

Analyzing Patient Safety Discussions in a Public Facebook Group Community

Introduction. Medical errors rank as a preventable cause of disability and death in the United States. The emergence of digital platforms such as social media has facilitated patient engagement in this topic and offers new avenues for understanding patient experiences. Methods. The first chapter of this thesis presents an overview of literature related to patient safety research as well as current challenges and trends with this research. Next, this thesis presents a stand-alone journal article consisting of a study analyzing content posted to a public patient safety Facebook group called the Patient Safety Action Network Community (PSANC) from November 21, 2022, to June 23, 2023. For this study, 200 posts were manually extracted and double-coded using a codebook developed through a grounded theory approach. The analysis involved descriptive statistics, cross-tabulations, and qualitative analysis. Results: The literature review uncovered a steadily increasing effort to include patient perspectives in patient safety research, but barriers remain. The analysis of Facebook posts revealed that 70.5% (n=141) were directly relevant to patient safety. Of relevant posts, the majority had a link to additional information (85.8%, n=121). Cross-tabulations showed a statistically significant association between posts containing links and discussions on patient empowerment and advocacy, infection-related discussions in the context of vulnerable populations, and between policy and advocacy discussions. Qualitative analysis revealed themes related to the emotional and physical impacts of medical errors on individuals and families, systemic challenges and advocacy, empowerment though education, and community support and shared experiences. Conclusions. Findings from the literature search and analysis of Facebook posts affirm persistent safety concerns and the evolving role of patients in healthcare discourse. Findings also suggest the necessity for nuanced policy reforms and the potential of digital engagement in enhancing patient safety and advocacy. These findings are important for public health in that they highlight the possibility of addressing healthcare disparities and managing costs through more inclusive and patient-centered care strategies

It Didn\u27t Start With You

Intergenerational trauma expert Mark Wolynn is joined in conversation by Richard Buggs, CIIS Dean of Alumni, to discuss how inherited family trauma shapes who we are and how he works with patients to end the cycle.https://digitalcommons.ciis.edu/publicprograms/1015/thumbnail.jp

Puff Bars, Tobacco Policy Evasion, and Nicotine Dependence: Content Analysis of Tweets

BackgroundPuff Bars are e-cigarettes that continued marketing flavored products by exploiting the US Food and Drug Administration exemption for disposable devices. ObjectiveThis study aimed to examine discussions related to Puff Bar on Twitter to identify tobacco regulation and policy themes as well as unanticipated outcomes of regulatory loopholes. MethodsOf 8519 original tweets related to Puff Bar collected from July 13, 2020, to August 13, 2020, a random 20% subsample (n=2661) was selected for qualitative coding of topics related to nicotine dependence and tobacco policy. ResultsOf the human-coded tweets, 2123 (80.2%) were coded as relevant to Puff Bar as the main topic. Of those tweets, 698 (32.9%) discussed tobacco policy, including flavors (n=320, 45.9%), regulations (n=124, 17.8%), purchases (n=117, 16.8%), and other products (n=110, 15.8%). Approximately 22% (n=480) of the tweets referenced dependence, including lack of access (n=273, 56.9%), appetite suppression (n=59, 12.3%), frequent use (n=47, 9.8%), and self-reported dependence (n=110, 22.9%). ConclusionsThis study adds to the growing evidence base that the US Food and Drug Administration ban of e-cigarette flavors did not reduce interest, but rather shifted the discussion to brands utilizing a loophole that allowed flavored products to continue to be sold in disposable devices. Until comprehensive tobacco policy legislation is developed, new products or loopholes will continue to supply nicotine demand

Psychometric evaluation of a caregiver diary for the assessment of symptoms of respiratory syncytial virus

Abstract Background There are no clinical outcome assessment (COA) tools developed in accordance with Food and Drug Administration (FDA) guidance suitable for the evaluation of symptoms associated with respiratory syncytial virus (RSV) infection among infants. The Gilead RSV Caregiver Diary (GRCD) is being developed to fulfill this need; the present research evaluates the GRCD and documents its reliability, validity, and responsiveness among children < 24 months of age with acute RSV infection. Methods A prospective, observational study was conducted in the United States during the 2014–2015 northern hemisphere winter season. Subjects were < 24-month, full-term, previously healthy infants with confirmed RSV infection and ≤5 days of symptoms. The GRCD was completed twice daily for 14 days by caregivers. Additional data were collected during the initial visit, subsequent visits, and end-of-study interview. Test-retest reliability (kappa and intraclass correlation coefficients [ICCs]), construct validity (correlations and factor analyses), discriminating ability (analyses of variance and chi-square), and responsiveness (effect sizes and standardized response means) were evaluated. Results A total of 103 subjects were enrolled (mean age 7.4 ± 5.3 months). GRCD items were grouped into different subscales according to question content, which, with the exception of the behavior impact domain (ICC = 0.43), demonstrated internal consistency (alphas = 0.78–0.94) and test-retest reliability (ICCs = 0.77–0.94). Hypothesized correlations with parent global ratings of RSV severity ranged from 0.45 to 0.70 and provided support for construct validity. Support for discriminating ability was limited. Effect sizes ranged from − 1.48 to − 4.40, indicating the GRCD was responsive to change. Conclusions These psychometric analyses support the validity, reliability, and responsiveness of the GRCD for assessing RSV symptoms in children < 24 months of age

Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content

Background: Misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) are increasing. Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the e-cigarette or vaping product use-associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This may have important public health ramifications for both COVID-19 control and ENDS use. Objective: Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study seeks to collect and classify Twitter messages ( tweets ) related to ENDS and COVID-19 to inform public health messaging. Methods: Approximately 2.1 million tweets matching ENDS-related keywords were collected from March 1, 2020, through June 30, 2020, and were then filtered for COVID-19-related keywords, resulting in 67,321 original tweets. A 5% (n=3366) subsample was obtained for human coding using a systematically developed codebook. Tweets were coded for relevance to the topic and four overarching categories. Results: A total of 1930 (57.3%) tweets were coded as relevant to the research topic. Half (n=1008, 52.2%) of these discussed a perceived association between ENDS use and COVID-19 susceptibility or severity, with 42.4% (n=818) suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (n=479, 24.8%) of tweets discussed the perceived similarity/dissimilarity of COVID-19 and EVALI, and 13.8% (n=266) discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. Conclusions: Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users; however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging

Additional file 1: of Psychometric evaluation of a caregiver diary for the assessment of symptoms of respiratory syncytial virus

Table S1. Inclusion/Exclusion Criteria for the GRCD Validation Study, Table S2 Schedule of Key Events for the GRCD Validation Study. (DOCX 17 kb