Quality Of Health Information Research Articles

Surfing for answers: Evaluating the quality of online health information for hereditary breast and ovarian cancer syndromes

Surfing for answers: Evaluating the quality of online health information for hereditary breast and ovarian cancer syndromes

Confronting Craniosynostosis: Maternal Concerns, Challenges, and Coping for their Children.

The study objective was to characterize shared online experiences surrounding craniosynostosis. Isolated and syndromic craniosynostosis-related consecutive posts (N = 700) made by patients and caregivers were extracted from TikTok and Instagram between 2017-2024. A cross-sectional qualitative analysis following guidelines for practical thematic analysis was performed. The majority of posts were by caregivers (96%) and by females (97%). Forty categorical subthemes from social media posts were synthesized into 4 predominant themes. Overarching thematic trends included Emotional and Psychological Support (47%), Medical Information and Treatment (27%), Family and Social Dynamics (15%), and Awareness, Education, and Advocacy (12%). Social media is used by caregivers, primarily mothers, for emotional support, processing health information, sharing experiences, raising awareness, and celebrating "cranioversaries." Male and patient perspectives were underrepresented. Physicians may use social media to gain insights, disseminate quality health information, and connect with patients.

Oral Diabetes Medication Videos on Douyin: Analysis of Information Quality and User Comment Attitudes.

Oral diabetes medications are important for glucose management in people with diabetes. Although there are many health-related videos on Douyin (the Chinese version of TikTok), the quality of information and the effects on user comment attitudes are unclear. The purpose of this study was to analyze the quality of information and user comment attitudes related to oral diabetes medication videos on Douyin. The key phrase "oral diabetes medications" was used to search Douyin on July 24, 2023, and the final samples included 138 videos. The basic information in the videos and the content of user comments were captured using Python. Each video was assigned a sentiment category based on the predominant positive, neutral, or negative attitude, as analyzed using the Weiciyun website. Two independent raters assessed the video content and information quality using the DISCERN (a tool for assessing health information quality) and PEMAT-A/V (Patient Education Materials Assessment Tool for Audiovisual Materials) instruments. Doctors were the main source of the videos (136/138, 98.6%). The overall information quality of the videos was acceptable (median 3, IQR 1). Videos on Douyin showed relatively high understandability (median 75%, IQR 16.6%) but poor actionability (median 66.7%, IQR 48%). Most content on oral diabetes medications on Douyin related to the mechanism of action (75/138, 54.3%), precautions (70/138, 50.7%), and advantages (68/138, 49.3%), with limited content on indications (19/138, 13.8%) and contraindications (14/138, 10.1%). It was found that 10.1% (14/138) of the videos contained misinformation, of which 50% (7/14) were about the method of administration. Regarding user comment attitudes, the majority of videos garnered positive comments (81/138, 58.7%), followed by neutral comments (46/138, 33.3%) and negative comments (11/138, 8%). Multinomial logistic regression revealed 2 factors influencing a positive attitude: user comment count (adjusted odds ratio [OR] 1.00, 95% CI 1.00-1.00; P=.02) and information quality of treatment choices (adjusted OR 1.49, 95% CI 1.09-2.04; P=.01). Despite most videos on Douyin being posted by doctors, with generally acceptable information quality and positive user comment attitudes, some content inaccuracies and poor actionability remain. Users show more positive attitudes toward videos with high-quality information about treatment choices. This study suggests that health care providers should ensure the accuracy and actionability of video content, enhance the information quality of treatment choices of oral diabetes medications to foster positive user attitudes, help users access accurate health information, and promote medication adherence.

Online Plain Language Tool and Health Information Quality

Complex and ineffective health communication is a critical source of health inequity and occurs despite repeated policy directives to provide health information that is easy to understand and applies health literacy principles. To evaluate the effectiveness of the Sydney Health Literacy Lab Health Literacy Editor, an easy-to-use online plain language tool that supports health information providers to apply health literacy guidelines to written health information. This randomized clinical trial, conducted online in Australia from May 2023 to February 2024, included a convenience sample of health information providers with no previous experience using the Health Literacy Editor. Analysts were blinded to study group. Participants were randomized 1:1 to the intervention or control group. Participants in the intervention group were provided access to the Health Literacy Editor and a 30-minute online training program prior to editing 3 prespecified health texts. The Health Literacy Editor gives objective, real-time feedback on words and sentences. Control participants revised the texts using their own standard health information development processes. The preregistered primary outcome was the text school grade reading score (using a validated instrument, the Simple Measure of Gobbledygook). Secondary outcomes were text complexity (percentage of text using complex language), use of passive voice (number of instances), and subjective expert ratings (5-point Likert scale corresponding to items on the Patient Education Materials Assessment Tool). A total of 211 participants were randomized, with 105 in the intervention group and 106 in the control group. Of 181 participants in the intention-to-treat analysis (mean [SD] age, 41.0 [11.6] years; 154 women [85.1%]), 86 were in the intervention group and 95 in the control group. Texts revised in the intervention group had significantly improved grade reading scores (mean difference [MD], 2.48 grades; 95% CI, 1.84-3.12 grades; P < .001; Cohen d, 0.99), lower text complexity scores (MD, 6.86; 95% CI, 4.99-8.74; P < .001; Cohen d, 0.95), and less use of passive voice (MD, 0.95 instances; 95% CI, 0.44-1.47 instances; P < .001; Cohen d, 0.53) compared with texts revised in the control group in intention-to-treat analyses. Experts rated texts in the intervention group more favorably for word choice and style than those in the control group (MD, 0.44; 95% CI, 0.25-0.63; P < .001; Cohen d, 0.63), with no loss of meaning or content. In this randomized clinical trial, the Health Literacy Editor helped users simplify health information and apply health literacy guidelines to written text. The findings suggest the tool has high potential to improve development of health information for people who have low health literacy. As an online tool, the Health Literacy Editor is also easy to access and implement at scale. ANZCTR Identifier: ACTRN12623000386639.

A scoping review to map public-facing websites for non-traumatic wrist disorders with quality evaluation

Introduction Public-facing resources for non-traumatic wrist disorders (NTWD) exist, but care recipients and healthcare professionals alike are uncertain where to access the most useful resources and have raised concerns over the quality of information provided. Previous studies involving stakeholders highlight a need for quality evaluation of these resources. The aim of this study was to identify website resources accessible to UK-based online health seekers and explore their content through quality assessment. Methods A scoping review of public-facing websites was conducted in accordance with Joanna Briggs Institute guidelines and PRISMA-ScR checklist. An a-priori search strategy was performed of publicly accessible websites using lay terms were entered into a simple Google search. The DISCERN tool was used to appraise the quality of health information with additional data charted to pre-determined criteria. Results The 82 websites meeting inclusion criteria scored an average of 2/5 DISCERN. Nine funding categories existed with private service websites were the most common. 18 different diagnoses were found with twenty different management interventions were recommended. Conclusion Considerable variation was found in the quality of websites providing information which people with NTWD are likely to access. Quality and trustworthiness of website information on NTWD are not the preserve of any sector or organisation and we identified potential for improvements across the board.

How college students evaluate the quality of online health information: A qualitative study

How college students evaluate the quality of online health information: A qualitative study

Pharmaceutical industry promotional activities on social media: a scoping review

Abstract Objectives The rise of social media has broadened the reach and impact of pharmaceutical promotion across countries. This scoping review synthesizes available literature on the nature, extent, and impacts of such promotion, with a particular focus on public health implications. Methods Using a systematic strategy, we searched six multidisciplinary scholarly databases for empirical studies, both peer-reviewed and grey, published since 2004, which had collected data on pharmaceutical promotion via social media. Data were synthesized qualitatively into outcome domains. Key findings We included 45 studies, primarily conducted in the USA (20/45, 44%) and multi-nationally (15/45, 33%), and published after 2013 (40/45, 89%). Studies used content analyses, surveys, and interviews to measure pharmaceutical industry presence or impacts on the following indicators: social media, social media strategy, consumer reach and engagement, health information quality, ethical and regulatory guideline adherence, and consumer attitudes and behaviours. Taken together, these studies indicate a gradual increase in industry use of social media, notably including the development of novel consumer engagement strategies, such as targeted promotion and influencer sponsorship. Studies also showed that, in some cases, health information provided on social media is of low quality, ethically and legally questionable, and potentially harmful to public health. Conclusions Appreciating the regulatory and reputational risks of consumer engagement on social media, the pharmaceutical industry has gradually increased promotional activities on social media since its inception. Evidence of harmful content and promotional activities that have become more covert and targeted suggests the need for regulatory development.

Assessing the Quality of Patient Education Materials on Cardiac Catheterization From Artificial Intelligence Chatbots: An Observational Cross-Sectional Study.

Background Health literacy empowers patients to participate in their own healthcare. Personal health literacy is one's ability to find, understand, and use information/resources to make well-informed health decisions. Artificial intelligence (AI) has become a source for the acquisition of health-related information through large language model (LLM)-driven chatbots. Assessment of the readability and quality of health information produced by these chatbots has been the subject of numerous studies to date. This study seeks to assess the quality of patient education materials on cardiac catheterization produced by AI chatbots. Methodology We asked a set of 10 questions about cardiac catheterization to four chatbots: ChatGPT (OpenAI, San Francisco, CA), Microsoft Copilot (Microsoft Corporation, Redmond, WA), Google Gemini (Google DeepMind, London, UK), and Meta AI (Meta, New York, NY). The questions and subsequent answers were utilized to make patient education materials on cardiac catheterization. The quality of these materials was assessed using two validated instruments for patient education materials: DISCERN and the Patient Education Materials Assessment Tool (PEMAT). Results The overall DISCERN scores were 4.5 for ChatGPT, 4.4 for Microsoft Copilot and Google Gemini, and 3.8 for Meta AI. ChatGPT, Microsoft Copilot, and Google Gemini tied for the highest reliability score at 4.6, while Meta AI had the lowest with 4.2. ChatGPT had the highest quality score at 4.4, while Meta AI had the lowest with 3.4. ChatGPT and Google Gemini had Understandability scores of 100%, while Meta AI had the lowest with 82%. ChatGPT, Microsoft Copilot, and Google Gemini all had Actionability scores of 75%, while Meta AI had one of 50%. Conclusions ChatGPT produced the most reliable and highest quality materials, followed closely by Google Gemini. Meta AI produced the lowest quality materials. Given the easy accessibility that chatbots provide patients and the high-quality responses that we obtained, they could be a reliable source for patients to obtain information about cardiac catheterization.

Abstract B105: Quality and Accessibility of Online Information Regarding CAR-T Therapy in Hematologic Malignancies

Abstract Background Chimeric antigen receptor T-cell (CAR-T) therapies have changed the treatment landscape for various hematologic malignancies and are currently under development and being tested in clinical trials for multiple solid tumors. Given that patients commonly use the internet as a source of health-related information, we sought to investigate the quality, understandability, and readability of online information regarding CAR-T therapy. Methods We conducted a search in a commonly used search engine (Google) of five pre-determined search terms to identify 100 unique web pages regarding CAR-T therapy. Scientific publications were excluded. Validated instruments were used to ascertain health information quality (DISCERN), understandability (Patient Education Materials Assessment Tool; PEMAT), and readability (Flesch-Kincaid, Gunning Fog, and SMOG indices). Results were summarized using descriptive statistics. Results Among the 100 web pages reviewed, 68% originated from academic medical centers, and 64% included links to clinical trials. Only 11% of the web pages included references to primary literature. 17% of web pages were available in a language other than English, with Spanish (15%) and Arabic (7%) being the most common. Moderate-to-high quality information (DISCERN ≥ 3) was presented by 47% of web pages, and only 31% of web pages were considered understandable (PEMAT ≥ 70%). Average readability scores were 10.6 (SD = 2.09), 12.6 (SD = 2.3), and 13.1 (SD = 1.7) using the Flesch-Kincaid, Gunning Fog, and SMOG indices, respectively. Conclusion Our study highlights that online information for CAR-T therapies commonly features low-quality health information that is typically not understandable to the general population. Further, contrary to recommendations from federal agencies and medical societies, available online information requires, on average, high school reading comprehension. Healthcare teams and stakeholders should strive to improve existing content and ensure patients have access to trusted, high-quality information given the unique complexities, processes, and toxicities associated with receiving CAR-T therapy. Citation Format: Luis C. Garcia, Ana I. Velázquez. Quality and Accessibility of Online Information Regarding CAR-T Therapy in Hematologic Malignancies [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B105.

Assessing the quality and readability of online patient information: ENT UK patient information e-leaflets vs responses by a Generative Artificial Intelligence.

The evolution of artificial intelligence has introduced new ways to disseminate health information, including natural language processing models like ChatGPT. However, the quality and readability of such digitally-generated information remains understudied. This study is the first to compare the quality and readability of digitally-generated health information against leaflets produced by professionals. Patient information leaflets for five ENT UK leaflets and their corresponding ChatGPT responses were extracted from the Internet. Assessors with various degree of medical knowledge evaluated the content using the Ensuring Quality Information for Patients (EQIP) tool and readability tools including the Flesch-Kincaid Grade Level (FKGL). Statistical analysis was performed to identify differences between leaflets, assessors, and sources of information. ENT UK leaflets were of moderate quality, scoring a median EQIP of 23. Statistically significant differences in overall EQIP score were identified between ENT UK leaflets but ChatGPT responses were of uniform quality. Non-specialist doctors rated the highest EQIP scores while medical students scored the lowest. The mean readability of ENT UK leaflets was higher than ChatGPT responses. The information metrics of ENT UK leaflets were moderate and varied between topics. Equivalent ChatGPT information provided comparable content quality, but with reduced readability. ChatGPT patient information and professionally-produced leaflets had comparable content, but LLM content were required a higher reading age. With the increasing use of online health resources, this study highlights the need for a balanced approach that considers optimises both the quality and readability of patient education materials.

Quality and Readability Analysis of Turbinoplasty on the Web.

This study aimed to assess the quality, credibility, and readability of online health information concerning turbinoplasty, given the increasing reliance on internet resources for health education. Using four search terms related to turbinoplasty, we analyzed 71 text-based webpages from Google.com, Bing.com, and Yahoo.com. Readability was evaluated using the Flesch-Kincaid grade level, Gunning-Fog Index, SMOG Index, and Coleman-Liau Index were utilized. Web page quality was computed through the DISCERN Instrument (DISCERN), the Journal of the American Medical Association benchmark criteria (JAMA), Novel Turbinoplasty Index (NTI), and presence of code certification by Health on The Net (HON). Seventy-one text-based web pages were assessed. Information quality was measured by an average DISCERN score of 47.4±7.40, indicating "fair" quality. The average readability was a grade level of 9.7±1.57, notably higher than AMA and NIH recommendations. Of all web pages, only 11 (15.49%) proficiently met all 4 listed JAMA criteria. Significant correlations between web page classification and average DISCERN (P=0.0042), as well as JAMA score (P<0.001) were discovered. The web pages that had HON code certification revealed significantly higher quality metrics such as DISCERN scores (P<0.001), JAMA scores (P<0.001), and NTI scores (P=0.038). Online health information for turbinoplasty is of "fair" quality, and the average readability is several grade levels above current AMA and NIH recommendations. Health care providers should aim to guide their patients on finding appropriate educational resources and should improve the readability of their patient education materials.

Assessment of the Quality and Readability of Web-Based Arabic Health Information on Halitosis: Infodemiological Study.

Halitosis, characterized by an undesirable mouth odor, represents a common concern. This study aims to assess the quality and readability of web-based Arabic health information on halitosis as the internet is becoming a prominent global source of medical information. A total of 300 Arabic websites were retrieved from Google using 3 commonly used phrases for halitosis in Arabic. The quality of the websites was assessed using benchmark criteria established by the Journal of the American Medical Association, the DISCERN tool, and the presence of the Health on the Net Foundation Code of Conduct (HONcode). The assessment of readability (Flesch Reading Ease [FRE], Simple Measure of Gobbledygook, and Flesch-Kincaid Grade Level [FKGL]) was conducted using web-based readability indexes. A total of 127 websites were examined. Regarding quality assessment, 87.4% (n=111) of websites failed to fulfill any Journal of the American Medical Association requirements, highlighting a lack of authorship (authors' contributions), attribution (references), disclosure (sponsorship), and currency (publication date). The DISCERN tool had a mean score of 34.55 (SD 7.46), with the majority (n=72, 56.6%) rated as moderate quality, 43.3% (n=55) as having a low score, and none receiving a high DISCERN score, indicating a general inadequacy in providing quality health information to make decisions and treatment choices. No website had HONcode certification, emphasizing the concern over the credibility and trustworthiness of these resources. Regarding readability assessment, Arabic halitosis websites had high readability scores, with 90.5% (n=115) receiving an FRE score ≥80, 98.4% (n=125) receiving a Simple Measure of Gobbledygook score <7, and 67.7% (n=86) receiving an FKGL score <7. There were significant correlations between the DISCERN scores and the quantity of words (P<.001) and sentences (P<.001) on the websites. Additionally, there was a significant relationship (P<.001) between the number of sentences and FKGL and FRE scores. While readability was found to be very good, indicating that the information is accessible to the public, the quality of Arabic halitosis websites was poor, reflecting a significant gap in providing reliable and comprehensive health information. This highlights the need for improving the availability of high-quality materials to ensure Arabic-speaking populations have access to reliable information about halitosis and its treatment options, tying quality and availability together as critical for effective health communication.

Quality Assessment of TikTok as a Source of Information About Mitral Valve Regurgitation in China: Cross-Sectional Study.

In China, mitral valve regurgitation (MR) is the most common cardiovascular valve disease. However, patients in China typically experience a high incidence of this condition, coupled with a low level of health knowledge and a relatively low rate of surgical treatment. TikTok hosts a vast amount of content related to diseases and health knowledge, providing viewers with access to relevant information. However, there has been no investigation or evaluation of the quality of videos specifically addressing MR. This study aims to assess the quality of videos about MR on TikTok in China. A cross-sectional study was conducted on the Chinese version of TikTok on September 9, 2023. The top 100 videos on MR were included and evaluated using quantitative scoring tools such as the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA) benchmark criteria, the Global Quality Score (GQS), and the Patient Education Materials Assessment Tool for Audio-Visual Content (PEMAT-A/V). Correlation and stepwise regression analyses were performed to examine the relationships between video quality and various characteristics. We obtained 88 valid video files, of which most (n=81, 92%) were uploaded by certified physicians, primarily cardiac surgeons, and cardiologists. News agencies/organizations and physicians had higher GQS scores compared with individuals (news agencies/organizations vs individuals, P=.001; physicians vs individuals, P=.03). Additionally, news agencies/organizations had higher PEMAT understandability scores than individuals (P=.01). Videos focused on disease knowledge scored higher in GQS (P<.001), PEMAT understandability (P<.001), and PEMAT actionability (P<.001) compared with videos covering surgical cases. PEMAT actionability scores were higher for outpatient cases compared with surgical cases (P<.001). Additionally, videos focused on surgical techniques had lower PEMAT actionability scores than those about disease knowledge (P=.04). The strongest correlations observed were between thumbs up and comments (r=0.92, P<.001), thumbs up and favorites (r=0.89, P<.001), thumbs up and shares (r=0.87, P<.001), comments and favorites (r=0.81, P<.001), comments and shares (r=0.87, P<.001), and favorites and shares (r=0.83, P<.001). Stepwise regression analysis identified "length (P<.001)," "content (P<.001)," and "physicians (P=.004)" as significant predictors of GQS. The final model (model 3) explained 50.1% of the variance in GQSs. The predictive equation for GQS is as follows: GQS = 3.230 - 0.294 × content - 0.274 × physicians + 0.005 × length. This model was statistically significant (P=.004) and showed no issues with multicollinearity or autocorrelation. Our study reveals that while most MR-related videos on TikTok were uploaded by certified physicians, ensuring professional and scientific content, the overall quality scores were suboptimal. Despite the educational value of these videos, the guidance provided was often insufficient. The predictive equation for GQS developed from our analysis offers valuable insights but should be applied with caution beyond the study context. It suggests that creators should focus on improving both the content and presentation of their videos to enhance the quality of health information shared on social media.

Evaluation of the Quality and Readability of Web-Based Information Regarding Foreign Bodies of the Ear, Nose, and Throat: Qualitative Content Analysis.

Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs. We aim to evaluate the quality and readability of available online health information relating to FBs. In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level. The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.

ChatGPT-4: Alcohol use disorder responses.

Alcohol use disorder (AUD) is characterized by low levels of engagement with effective treatments. Enhancing awareness of AUD treatments and how to navigate the treatment system is crucial. Many individuals use online sources (e.g. search engines) for answers to health-related questions; web-based results include a mix of high- and low-quality information. Artificial intelligence may improve access to quality health information by providing concise, high-quality responses to complex health-related questions. This study evaluated the quality of ChatGPT-4 responses to AUD-related queries. A comprehensive list of 64 AUD-related questions was developed through a combination of Google Trends analysis and expert consultation. ChatGPT-4 was prompted with each question, followed by a request to provide 3-5 peer-reviewed scientific citations supporting each response. Responses were evaluated for whether they were evidence-based, provided a referral and provided supporting documentation. ChatGPT-4 responded to all AUD-related queries, with 92.2% (59/64) of responses being fully evidence-based. Although only 12.5% (8/64) of responses included referrals to external resources, all responses (100%; 5/5) to location-specific ('near me') queries directed individuals to appropriate resources like the NIAAA Treatment Navigator. Most (85.9%; 55/64) responses to the follow-up question provided supporting documentation. ChatGPT-4 responds to alcohol use disorder-related questions with evidence-based information and supporting documentation. ChatGPT-4 could be promoted as a reasonable resource for those looking online for alcohol use disorder-related information.

Associations between patient portal use and electronic health record (EHR) data timeliness in type 2 diabetes mellitus care

Abstract Objective Patient data is subject to missingness and errors. Patient portals enable patients managing type 2 diabetes mellitus (T2DM) to review and correct data to avoid retesting, medication errors, and diagnostic mistakes. We examined whether patient portal use was associated with electronic health record (EHR) data timeliness in T2DM care. Research Design and methods We analyzed EHR data from a panel of adult patients to determine whether portal use improved data timeliness. EHR data timeliness is measured as the number of days between patient encounters, accounting for mean attribute update periods, where available EHR attribute updates for T2DM measurements were present, including body mass, weight, glycated hemoglobin A1c, cholesterol, blood pressure, serum creatinine, and smoking status. We performed negative binomial regressions with fixed effects to estimate the association between patient portal use and EHR data timeliness. Sensitivity analyses were conducted using Poisson regressions. Results Nearly a third (31.3%) of patients in our sample actively used the health portal. There were fewer days (111.9 days vs. 136.7 days; p &lt; 0.001) between EHR attribute updates for patients who used health portals compared to patients who did not. Data timeliness was lower among female, non-Hispanic White Medicare beneficiaries. Based on regression analyses, portal use was associated with an expected 3.6 (p &lt; 0.001) percentage point decrease in days between attribute updates, indicating improved EHR timeliness. Conclusion Improving the quality of health information may streamline decision-making in partnership with patients who produce data points across clinical settings. Active use of patient portals and digital health tools in chronic disease care are critical for care management and clinical decision-making, especially for patients managing type 2 diabetes across clinical settings.

TikTok content on measles-rubella vaccine in Jordan: A cross-sectional study highlighting the spread of vaccine misinformation.

Social media platforms, including TikTok, have become influential sources of health information. However, they also present as potential sources for the spread of vaccine misinformation. The aim of this study was to assess the quality of measles-rubella (MR) vaccine-related contents on TikTok in Jordan and to analyze factors associated with vaccine misinformation. A systematic search for MR vaccine-related TikTok contents in Jordan was conducted using pre-defined keywords and a specified time range. Content metrics (likes, comments, shares, and saves) were collected while the content quality of health information was evaluated using a modified version of the DISCERN, a validated instrument by two expert raters. The average modified DISCERN score ranged from 1, denoting poor content, to 5, indicating excellent content. A total of 50 videos from 34 unique content creators formed the final study sample. The majority of MR vaccine-related content was created by lay individuals (61.8%), followed by TV/news websites/journalists (23.5%), and healthcare professionals (HCPs) (14.7%). The Cohen κ per modified DISCERN item was in the range of 0.579-0.808, p<0.001), indicating good to excellent agreement. The overall average modified DISCERN score was 2±1.2, while it was only 1.3±0.52 for lay individuals' content, which indicated poor content quality. For the normalized per number of followers for each source, content by lay individuals had a significantly higher number of likes, saves, and shares with p=0.009, 0.012, and 0.004, respectively. Vaccine misinformation was detected in 58.8% of the videos as follows: lay individuals (85.7%), TV/news websites/journalists (25.0%), and HCPs content had none (p<0.001). Normalized per the number of followers for each source, videos flagged as having MR vaccine misinformation reached a higher number of likes, saves, and shares (p=0.012, 0.016, and 0.003, respectively). In conclusion, substantial dissemination of TikTok MR vaccine-related misinformation in Jordan was detected. Rigorous fact-checking is warranted by the platform to address misinformation on TikTok, which is vital to improve trust in MR vaccination and ultimately protect public health.

Evaluating Health Literacy Resources for Secondary Hyperparathyroidism in End-Stage Kidney Disease

IntroductionParathyroidectomy is recommended for severe secondary hyperparathyroidism (SHPT) due to end-stage kidney disease (ESKD), but surgery is underutilized. High quality and accessible online health information, recommended to be at a 6th-grade reading level, is vital to improve patient health literacy. This study evaluated available online resources for SHPT from ESKD based on information quality and readability. MethodsThree search engines were queried using the terms “parathyroidectomy for secondary hyperparathyroidism,” “parathyroidectomy kidney/renal failure,” “parathyroidectomy dialysis patients,” “should I have surgery for hyperparathyroidism due to kidney failure?,” and “do I need surgery for hyperparathyroidism due to kidney failure if I do not have symptoms?” Websites were categorized by source and origin. Two independent reviewers determined information quality using JAMA (0-4) and DISCERN (1-5) frameworks, and scores were averaged. Cohen's kappa evaluated inter-rater reliability. Readability was determined using the Flesch Kincaid Reading Ease, Flesch Kincaid Grade Level, and Simple Measure of Gobbledygook tools. Median readability scores were calculated, and corresponding grade level determined. Websites with reading difficulties >6th grade level were calculated. ResultsThirty one (86.1%) websites originated from the U.S., with most from hospital-associated (63.9%) and foundation/advocacy sources (30.6%). The mean JAMA and DISCERN scores for all websites were 1.3 ± 1.4 and 2.6 ± 0.7, respectively. Readability scores ranged from grade level 5–college level, and most websites scored above the recommended 6th grade level. ConclusionsPatient-oriented websites tailoring SHPT from ESKD are at a reading level higher than recommended, and the quality of information is low. Efforts must be made to improve the accessibility and quality of information for all patients.

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p&lt;0.001), more positive attitudes towards these behaviors (p&lt;0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p&lt;0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

Patient-Engagement Health Information Technology and Quality Process Outcomes in Federally Qualified Health Centers.

Health information technology (HIT) for patient-engagement can positively influence the quality and efficiency of health care delivery. Although this topic is of significant importance, it has not been fully addressed in the federally qualified health center (FQHC) context. This research investigates the relationship between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. Based on the Uniform Data System (UDS), this study employed multivariable regression analysis to investigate the association between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. FQHCs were placed in 4 mutually exclusive groups based on the level of FQHC use of patient-engagement HIT. The results indicate that compared with the most comprehensive patient-engagement HIT at FQHCs, less comprehensive patient-engagement HIT was associated with lower rates of preventive care provision. Comprehensive patient-engagement HIT across FQHCs may improve preventive health care quality outcomes. The results support policy incentives for FQHCs with less comprehensive levels of patient-engagement HIT to foster improved preventive care for their patients.