Sharing Health Information Research Articles

Ethical and legal governance of health-related research that use digital data from user-generated online health content

ABSTRACT Advances in information and communication technologies have enabled health care users and providers to share health information online thus generating contents, which may be used for health-related research. In addition, the data may be used for health care decision-making thus blurring the boundaries between health care and research particularly with the repurposing of data for other uses. This paper discusses the ethical and legal concerns that emerge from using digital data from user-generated online health content for health-related research. It analyses the nature of digital health data from user-generated online content and considers the extent to which its use can be governed through the current regulatory and ethical frameworks. It then highlights the strengths and weaknesses of these frameworks and proposes strategies that can be used to protect data subjects’ privacy while facilitating research in an ethical manner.

Design of the CAPABLE Health Empowerment Tool: Citizens' Needs and Expectations.

It is important but difficult for citizens to gain a proper overview of their health-related information. The CAPABLE project aims to create a digital tool that enable citizens to actively utilize their clinical and personal health information to manage medication, improve nutrition, and facilitate health services coordination. 57 participants have participated in various user-centered co-creation activities. A key finding of citizen's needs and expectations is that citizens are positive about such a tool provided it is easy to use and requires minimal work. Especially, opportunities to collect and utilize already existing digital health information, having access to personalized and relevant checklists and personalized resources, and be able to share health information with health personnel and others according to their own trust and privacy preferences. Involving other stakeholders to ensure integration with other systems is of principal importance to fulfil citizens' expectations of integration and automatization.

Abstract D010: Developing an inflammatory breast cancer campaign: Results from focus groups led by Komen scholars

Abstract Introduction: Breast cancer (BC) remains the second leading cause of cancer deaths amongst women worldwide. In the United States, African American and Latino women are disproportionately burdened by the incidence and mortality of BC compared with Caucasian women. Inflammatory breast cancer (IBC) is a rare and aggressive form of BC. African American women are more likely to be diagnosed with IBC and at earlier age compared to whites. IBC frequently lacks a breast lump and hence is difficult to detect. IBC is often diagnosed late at stage III or IV and has worse prognosis than non-IBC BC. Critically, awareness of IBC continues to lag education on other breast cancers. Lifesaving information and resources to reduce cancer risks are not widespread amongst minority populations. Community engagement is a valuable asset that enhances the traditional biomedical scientist’s knowledge in understanding the connection between biological and social factors affecting a particular disease, with the goal of addressing, and ultimately diminishing, BC health disparities. Methods: The purpose of the focus groups were to determine the best methods and messages for community outreach to raise awareness about IBC. To follow up on our initial listening session at the 4th Annual Women’s Health Awareness Day at NCCU, several focus groups were engaged, each with 10-12 participants from various gender, racial, and economic demographics, recruited from the Raleigh and Durham communities. Participants were provided informed consent forms and demographic surveys to complete. With guidance and training from the Komen mentoring team, trainees crafted a marketing plan and focus group session guide. Trainees served as session moderators and note-takers and developed summary reports which highlighted themes from the sessions which included the following topics: knowledge of IBC, best methods for sharing health information, types of messages to raise awareness and promote action, and perceived barriers to breast cancer screening. Results: Information gathered from the focus group sessions provides a unique perspective to strategize and develop marketing campaigns to bring awareness to the community and minority populations in the community. Many participants were unfamiliar with IBC, how it is diagnosed, and treatment options. To better raise awareness about IBC, participants recommended the use of various social media platforms, promoting more one-on-one education, patient self-advocacy sessions, and changing the perception of the presence of lumps as an indicator of BC. Conclusion: Cancer incidence and mortality overall are declining in all groups in the United States; however, minority groups continue to suffer with increased risk of developing or dying from BC. Furthermore, there is a significant need to raise awareness and understanding of IBC in diverse communities. Partnerships between the community and researchers will facilitate the development of relevant and accessible information about IBC. Citation Format: Portia L Andrews, Alanna Burwell, Maria S Dixon, Hamzah Kharabsheh, Dana M Gant, Tia A Tate, Hassan Shehata, Jodie M Fleming, Kearston L Ingraham, Seronda A Robinson, Nadine J Barrett, Kevin P Williams. Developing an inflammatory breast cancer campaign: Results from focus groups led by Komen scholars [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D010.

The impact of data entry structures on perceptions of individuals with chronic mental disorders and physical diseases towards health information sharing

Background and objectiveCollecting, integrating, and sharing mental and physical health information can enhance the care process of patients and improve the completeness of patient databases in the health information exchange (HIE) networks. There is a need to encourage patients with physical and mental disorders to share their health information with providers. Data entry interfaces are suggested as an important factor affecting the quality of information. However, little is known about whether individuals with different diseases (mental and physical) care for the data entry structure in sharing personal health information (PHI). Materials and methodsWe conduct four experiments to examine the impact of different health problems (mental vs. physical) and types of data entry interfaces (structured vs. unstructured) on individuals' perceptions of information quality and their willingness to share their health information. ResultsFindings demonstrate that the type of disease and degree of data entry structure significantly influence individuals' perceptions of usefulness, accessibility, concise presentation, understandability, psychological risk, privacy concern, stigma, and willingness to share health information. DiscussionPeople with mental disorders prefer structured data interfaces as they perceive that a high degree of data entry structure can protect their privacy and mitigate stigma and psychological risk more than unstructured interfaces. Individuals with physical illnesses favor structured interfaces for their format, which is brief, comprehensive, accessible, useful, and understandable. People suffering from physical diseases are more likely to share their information when a highly-structured data entry interface is used. Moreover, individuals with mental disorders are less likely to disclose their information when providers collect health records using an unstructured data entry interface. ConclusionsThis study suggests that the best level of structure for data entry interfaces could be designed at the point of care consistent with patients' health status and their type of diseases to improve the success of HIE networks.

Non-Hispanic White Mothers’ Willingness to Share Personal Health Data With Researchers: Survey Results From an Opt-in Panel

BackgroundAdvances in information communication technology provide researchers with the opportunity to access and collect continuous and granular data from enrolled participants. However, recruiting study participants who are willing to disclose their health data has been challenging for researchers. These challenges can be related to socioeconomic status, the source of data, and privacy concerns about sharing health information, which affect data-sharing behaviors.ObjectiveThis study aimed to assess healthy non-Hispanic white mothers’ attitudes in five areas: motivation to share data, concern with data use, desire to keep health information anonymous, use of patient portal and willingness to share anonymous data with researchers.MethodsThis cross-sectional study was conducted on 622 healthy non-Hispanic white mothers raising healthy children. From a Web-based survey with 51 questions, we selected 15 questions for further analysis. These questions focused on attitudes and beliefs toward data sharing, internet use, interest in future research, and sociodemographic and health questions about mothers and their children. Data analysis was performed using multivariate logistic regressions to investigate the factors that influence mothers’ willingness to share their personal health data, their utilization of a patient portal, and their interests in keeping their health information anonymous.ResultsThe results of the study showed that the majority of mothers surveyed wanted to keep their data anonymous (440/622, 70.7%) and use patient portals (394/622, 63.3%) and were willing to share their data from Web-based surveys (509/622, 81.8%) and from mobile phones (423/622, 68.0%). However, 36.0% (224/622) and 40.5% (252/622) of mothers were less willing to share their medical record data and their locations with researchers, respectively. We found that the utilization of patient portals, their attitude toward keeping data anonymous, and their willingness to share different data sources were dependent on the mothers’ health care provider status, their motivation, and their privacy concerns. Mothers’ concerns about the misuse of personal health information had a negative impact on their willingness to share sensitive data (ie, electronic medical record: adjusted odds ratio [aOR] 0.43, 95% CI 0.25-0.73; GPS: aOR 0.4, 95% CI 0.27-0.60). In contrast, mothers’ motivation to share their data had a positive impact on disclosing their data via Web-based surveys (aOR 5.94, 95% CI 3.15-11.2), apps and devices designed for health (aOR 5.3, 95% CI 2.32-12.1), and a patient portal (aOR 4.3, 95% CI 2.06-8.99).ConclusionsThe findings of this study suggest that mothers’ privacy concerns affect their decisions to share sensitive data. However, mothers’ access to the internet and the utilization of patient portals did not have a significant effect on their willingness to disclose their medical record data. Finally, researchers can use our findings to better address their study subjects concerns and gain their subjects trust to disclose data.

Social Capital and Health Communication in Singapore: An Examination of the Relationships between Community Participation, Perceived Neighborliness and Health Communication Behaviors

Social capital is a collective characteristic of communities that determines the health and well-being of populations. There is ample evidence supporting the link between social capital and health; however, less is known about the relationship between social capital and health communication behaviors. Our study aimed to investigate the relationships between social capital and health communication in Singaporean adults aged 21 years and above. Cross-sectional data (N = 1,012) were collected from the Singapore Population Health Studies (SPHS) Online Panel. Three main outcome variables assessing health communication behaviors in the past 12 months were (1) health information-seeking; health information-sharing (2) with family members and (3) with friends and coworkers. Two components of social capital were assessed: structural component (i.e., community participation) and cognitive component (i.e., perceived neighborliness). Regression analyses found that community participation and perceived neighborliness were significantly associated with health information-seeking. The analyses also found that perceived cohesion was a significant correlate of health information-sharing with family members. Finally, moderation tests indicated that perceived neighborliness moderated the relationships between trust in information sources and health communication (health information-seeking and health information-sharing with friends/coworkers). Findings have implications for community-based health interventions and social policies to strengthen community participation and cohesion.

Understanding the evolving preferences for use of health information technology among adults with self reported anxiety and depression in the U.S

Abstract Recent evidence suggests consumer health information technologies are increasingly utilized among those with medical conditions towards improving health and recovery. However, there is also increasing evidence that many patients, especially those with mental health conditions like depression and anxiety, may struggle to utilize these apps given issues with usability and engagement. Further, there is a paucity of literature on differences in the preference for using technologies such as smartphone apps for mental health patients compared to other patient populations. The purpose of this study is to evaluate the preferences and use of technology for health information exchange within a nationally-representative sample of adults with and without mental illness and to assess whether these preferences differ according to sociodemographic factors. For our analysis, we utilized data from the 2017 (HINTS 5 cycle 1) and 2018 (HINTS 5 cycle 2) iterations of the Health Information National Trends Survey (n = 6789). We used multivariate logistic regression to identify factors associated with a higher or lower rate of using health information technology (HIT) in persons with or without mental illness. We adjusted these models for the sociodemographic variables of age, sex, household income, education level, employment status, health insurance status, marital status, and race. Of the 6789 participants, 1538 reported having depression and/or an anxiety disorder. In both the adjusted and unadjusted models, ownership of smartphones, tablet computers, health apps, and utilization of the internet did not differ by depression or anxiety status. Furthermore, in the adjusted models, those with depression and/or anxiety had a significantly higher likelihood of using electronic means such as computers and smartphones to search for health information, look up test results, communicate with a physician, and to share health information. However, these individuals were also more likely to withhold information from their health care providers due to concerns about the security or privacy of their medical records. Our analysis shows that while ownership rates for smartphones and the use of health apps did not differ by mental health status, there was an increased likelihood of those with mental illness to use health information tools in communicating with their health providers. However, concerns about data security and privacy may hinder the utilization and integration of these technologies in mental health care. Future efforts should focus on ensuring patient privacy and data protection to maximize the benefits of digital technology in mentally ill populations.

Using Social Media as a Platform to Promote Nutrition Messaging of FLIP

Social media is an ever growing and versatile medium that presents a novel avenue for health promotion and sharing health information. Despite its growth and popularity, literature is limited on how social media can be used for health promotion interventions, particularly related to food and nutrition. The Food Literacy Intervention Program (FLIP) at the University of Alberta is an evidence-based tailored program targeted at families with children aged 3 to 5. FLIP was designed based on the results of a needs assessment to promote healthy eating in children and improve food knowledge and skills of families. In previous years, FLIP was primarily an in-person cooking class for families and children with a limited online component. Parents had expressed a desire for quick and easy access to credible online nutrition. Therefore, over the course of a 12-week MPH practicum, the online FLIP program was developed and implemented for 2019. The goal of the online program was to explore different forms of social media as a platform to reach a larger audience for the promotion of evidence-based nutrition content. Content was produced for Instagram, Facebook, and a blog, and varying strategies were used to tailor the content to each platform. Social media metrics, including reach and engagement, were captured and analysed to evaluate the effectiveness of the program. This project contributes to the knowledge and understanding of the role of social media for promoting health messages and provides a basis upon which future projects can be created.

Health Consumers' Daily Habit of Internet Banking Use as a Proxy for Understanding Health Information Sharing Behavior: Quasi-Experimental Approach.

BackgroundAs the US health care system is embracing data-driven care, personal health information (PHI) has become a valuable resource for various health care stakeholders. In particularly, health consumers are expected to autonomously manage and share PHI with their health care partners. To date, there have been mixed views on the factors influencing individuals’ health data–sharing behaviors.ObjectiveThis study aimed to identify a key factor to better understand health information sharing behavior from a health consumer’s perspective. We focused on daily settings, wherein health data–sharing behavior becomes a part of individuals’ daily information management activities. Considering the similarity between health and finance information management, we explicitly examined whether health consumers’ daily habit of similar data sharing from the financial domain affects their PHI-sharing behaviors in various scenarios.MethodsA Web-based survey was administered to US health consumers who have access to and experience in using the internet. We collected individual health consumers’ intention to share PHI under varying contexts, habit of financial information management (operationalized as internet banking [IB] use in this paper), and the demographic information from the cross-sectional Web-based survey. To isolate the effect of daily IB on PHI-sharing behaviors in everyday contexts, propensity score matching was used to estimate the average treatment effect (ATE) and average treatment effect on the treated (ATET) regarding IB use. We balanced the treatment and control groups using caliper matching based on the observed confounding variables (ie, gender, income, health status, and access to primary care provider), all of which resulted in a minimal level of bias between unmatched and matched samples (bias <5%).ResultsA total of 339 responses were obtained from a cross-sectional Web-based survey. The ATET results showed that in terms of sharing contents, those who used IB daily were more likely to share general information (P=.01), current information (P=.003), and entire data (P=.04). Regarding occasions for sharing occasions, IB users were prone to share their information in all cases (P=.02). With regard to sharing recipients, daily IB users were more willing to share their personal health data with stakeholders who were not directly involved in their care, such as health administrators (P=.05). These results were qualitatively similar to the ATE results.ConclusionsThis study examined whether daily management of similar information (ie, personal financial information) changes health consumers’ PHI-sharing behavior under varying sharing conditions. We demonstrated that daily financial information management can encourage health information sharing to a much broader extent, in several instances, and with many stakeholders. We call for more attention to this unobserved daily habit driven by the use of various nonhealth technologies, all of which can implicitly affect patterns and the extent of individuals’ PHI-sharing behaviors.

Understanding Community-based HIV/AIDS Service Organizations: An Invaluable Source of HPV-related Cancer Information for At-risk Populations

To describe non-clinical HIV service providers (NCHSPs) as surrogate seekers and health information mavens for people living with HIV (PLWH), men who have sex with men (MSM), and other vulnerable populations.In May/June 2016, we recruited 30 NCHSPs from three community-based HIV/AIDS service organizations. NCHSPs completed a 118-item self-administered, paper-and-pencil survey about HPV, cancer, and health communication. Data were analyzed using Stata/SE 14.1.Almost all (97%) NCHSPs were surrogate seekers and had looked for HIV/AIDS (97%), STD (97%), and cancer (93%) information. Most (60%) cancer information seekers had looked for information about HPV. The Internet (97%) and healthcare providers (97%) were health information sources almost all NCHSPs trusted. Nearly all NCHSPs (93%) were completely or very confident about their ability to find health information. The mean health information mavenism score (17.4 ± 2.1) was significantly higher than the scale’s high-score cutoff (15.0) (p < 0 .001).NCHSPs look for and share health information with the vulnerable populations (e.g., PLWH, MSM) they serve. More research is needed to understand what NCHSPs’ know and think about the health information they are sharing with vulnerable populations.

Healthy Data Protection

Healthy Data Protection

Fog and Cloud Computing Assisted IoT Model Based Personal Emergency Monitoring and Diseases Prediction Services

Along with the rapid development of modern high-tech and the change of people's awareness of healthy life, the demand for personal healthcare services is gradually increasing. The rapid progress of information and communication technology and medical and bio technology not only improves personal healthcare services, but also brings the fact that the human being has entered the era of longevity. At present, there are many researches focused on various wearable sensing devices and implant devices and Internet of Things in order to capture personal daily life health information more conveniently and effectively, and significant results have been obtained, such as fog computing. To provide personal healthcare services, the fog and cloud computing is an effective solution for sharing health information. The health big data analysis model can provide personal health situation reports on a daily basis, and the gene sequencing can provide hereditary disease prediction. However, the injury mortality and emergency diseases since long ago caused death and great pain for the family. And there are no effective rescue methods to save precious lives and no methods to predict the disease morbidity likelihood. The purpose of this research is to capture personal daily health information based on sensors and monitoring emergency situations with the help of fog computing and mobile applications, and disease prediction based on cloud computing and big data analysis. Through the comparison of test results it was proved that the proposed emergency monitoring based on fog and cloud computing and the diseases prediction model based on big data analysis not only gain more of the rescue time than the traditional emergency treatment method, but they also accumulate lots of different personal healthcare related experience. The Taian 960 hospital of PLA and the Yanbian Hospital as IM testbed were joined to provide emergency monitoring tests, and to ensure the CVD and CVA morbidity likelihood medical big data analysis, the people around Taian city participated in personal health tests. Through the project, the five network layers architecture and integrated MAPE-K Model based EMDPS platform not only made the cooperation between hospitals feasible to deal with emergency situations, but also the Internet medicine for the disease prediction was built.

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities.

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities.

The contemporary role and potential of pharmacist contribution for community health using social media.

Background Social media (SM) is everywhere, and it affects all aspects of life, including health care. This study aimed to identify pharmacist activity in SM and explore the potential for pharmacist contributions using SM. Methods Focus group discussions (FGDs) were conducted in four cities in Indonesia. The investigators collaborated with a local pharmacist association to select a wide range of pharmacists as participants. The discussions were audiotaped, transcribed, and thematically analyzed. Results Forty-one pharmacists participated in the FGDs. Four broad themes were identified: pharmacist use of SM, current initiatives using SM, public acceptance, and opportunities for role expansion. WhatsApp was the most used SM and had meaningful contribution to spread information and change a patient's behavior. Participants used SM mainly for personal purposes, but when it came to pharmacy and health issues, they were among the first to be contacted by patients or to counter misleading information in SM. A number of participants actively used SM for health promotion in form of sharing health information, promoting use of medicines, providing drug reminders, and encouraging compliance to medication. The public had a high trust to information provided by pharmacists in SM. Although participants believed pharmacists can play a role in educating patients and influencing the health of the communities, they considered being active in SM as burdensome, time consuming, and potential for lawsuit. Conclusions SM has become a venue for pharmacists to improve the health of the people. Several unique features in SM may facilitate pharmacist contributions; however, whether pharmacists continue to undertake such initiative cannot be guaranteed.

Low rates of cascade genetic testing among families with hereditary gynecologic cancer: An opportunity to improve cancer prevention

ObjectiveCascade genetic testing (CGT) of hereditary breast and ovarian cancer (HBOC) or Lynch Syndrome (LS) patients’ relatives offers opportunities to prevent cancer, but CGT rates are not well described. We aimed to measure reported disclosure of genetic testing results and CGT rates in these families and evaluate patients’ views of educational media. MethodsPatients with HBOC or LS identified from germline genetic testing at an academic institution between 2011 and 2016 were surveyed regarding disclosure, testing among relatives, and perceptions of educational materials. Medical records and pedigrees provided numbers of total and first-degree relatives. ResultsOf 103 mutation carriers consented, 64 (63%) completed the survey an average of 38 months after receiving genetic testing results. Participants’ mean age was 53 years, and thirty-one (48%) had a cancer diagnosis. The majority (86%) felt extremely or very comfortable sharing health information. Participants disclosed results to 87% of first-degree relatives, but reported that only 40% of first-degree relatives underwent testing. First-degree female relatives had significantly higher CGT rates than first-degree male relatives (59% versus 21%, P < 0.001). Participants with HBOC reported higher CGT rates than those with LS (49% versus 33%, P = 0.02). Participants did not identify any one educational medium as more helpful than the others for disclosing results. ConclusionDisclosure rates are high among HBOC and LS mutation carriers, but reported CGT rates are low. Gender- and mutation-specific barriers prevent patients’ family members from undergoing CGT. Future studies should implement materials to address these barriers and improve CGT rates.

Social media engagement and health

Main AimThe Digital Health Survey was the first nationally representative survey in Wales aiming to understand the extent to which people use social media, disclose personal health related information through social media sites and different user patterns across population groups.&#x0D; MethodsA nationally representative household sample (n=1,252) was identified by a probabilistic sampling approach. One individual, aged 16 years and older, per household was randomly invited to complete a face-to-face questionnaire between April and June 2018. The survey collected quantitative information on use of social media platforms, perception of sharing personal health information on social media platforms, health status and socio-demographic characteristics. We tested the relationships among use, user type, demographics and health status using Chi-squared test or Fisher’s exact test correspondingly. Using estimated marginal means (and 95% confidence intervals), adjusted proportions of people who reported their use on social media platforms was calculated by adjusted mean, controlling for confounders.&#x0D; Results76.9% of the Welsh population engaged with social media, including 64.7% who used one or more form of social media platform on a daily basis. The most frequently used (i.e. daily) social media platform was Facebook (50.6% of the Welsh population including 23.4% used several times a day). Within the population sampled, controlling for confounders, significant higher proportion of women (91%) users were found compared to men (86%). 99.6% of 16-29 years old used social media with significant lower proportions for older age groups (i.e. 75.6% for 60-69 and 59.8% for 70+). No significant differences were found between social media engagement and deprivation quintiles. 9.6% shared personal health information on social media with friends and family, while only 2.7% shared health information with people they did not know.&#x0D; ConclusionPatterns in social media use are an important consideration for health promotion. The absence of a difference by deprivation groups suggests this approach may reach population more traditional routes have not. However, continued reduction in a digital divide and development of effective solutions for health via social media remains a priority.

“THEY DON’T TELL YOU ANYTHING”: ETHICS OF PRIVACY AND SOCIAL RELATIONSHIPS IN ASSISTED LIVING

The Health Insurance Portability and Accountability Act was developed to ensure patient privacy. Yet in assisted living (AL), social connectedness—which is associated with positive sense of self and well-being—may conflict with privacy regulations restricting information sharing. These regulations, while intended to protect, rely on a traditional conception of autonomy that foregrounds self-determination, freedom of choice, and freedom from outside interference, rather than a relational definition that acknowledges dependency, interdependence, and care relationships. We sought to identify health information sharing practices in AL that help or hinder residents’ ability to maintain a positive sense of self. We conducted a thematic analysis with secondary data (61 interviews with residents and their informal and formal caregivers, 916 hours of ethnographic observation) from one large (125 beds) AL community in Atlanta enrolled in a 5-year NIA-funded end-of-life study (5R01AG047408). We examined these data to determine how health information is shared in AL, and the valence of different sharing practices. Findings showed that exchanging information about shared life stage and health circumstances built community within AL. Conversely, receiving partial or inadequate health information frustrated residents. Medical information could be inferred from environmental cues, but many residents felt these cues harmfully “medicalized” social space. Negotiating privacy boundaries required staff and resident compromise. These results indicate divergence between AL policies intended to preserve privacy, and resident values emphasizing social relationships and bonding. A relational perspective may be valuable in developing alternatives for residents wishing to share health information with peers.

The use of digital devices in the field of healthcare in Bulgaria

Abstract Background The opportunities that information and communication technologies provide in the field of healthcare are many and constantly growing. Thanks to them, consumers have access to health information, consultations and remote treatment and connection with medical centers. They help to improve health promotion activities, whose mission is to promote health as a core value. The aim of the present study is to explore the attitudes regarding the use of digital devices in the field of healthcare of Bulgarian population. Methods A direct anonymous survey was conducted among 356 respondents, randomly selected and with an average age of 38.26 ± 0.15 (110 men and 246 women). The study was conducted from October 2018 to April 2019. The data analysis was performed using the statistical software SPSS v.23.0. Results The results showed that 78.9% of respondents have used or are willing to use digital devices to search for and record health information. A statistical gender difference was found in the answer to the question of using a digital device for self-registration of information (χ2 = 28.6, P &amp;lt; 0.05), as women are more likely to do so. More than 75% of respondents are willing to share health information with a medical professional in real-time via the internet. Older people are more reserved and hesitant about providing health information to a state agency (66.7%). The smartphone and computer/laptop are among the most preferred digital modalities in the healthcare field, with men and younger respondents more likely to use digital devices in relation to their health (χ2=39.9, P &amp;lt; 0.05). Women are more critical about the use of information and communication technologies in healthcare (χ2=48.2, P &amp;lt; 0.05). Conclusions The present study found a positive attitude among all respondents towards the introduction of modern technologies in the healthcare field and the opportunity of remote contact with medical professionals, using personal digital devices. Key messages The opportunities that information and communication technologies provide in the field of healthcare are many and constantly growing. The aim of the present study is to explore the attitudes regarding the use of digital devices in the field of healthcare of Bulgarian population.

Public's Attitudes Toward Health Information on Twitter: A Cross-sectional Survey Based on the Saudi Population.

Health information dissemination through social media networks has transformed the process of communication between health practitioners, patients, and the public. Twitter is one of the most commonly used social media networks in Saudi Arabia for sharing health information. However, the reliability of health information on Twitter has been questioned by some skeptics, thereby placing the public at a significant health risk. This study was conducted to assess the attitudes of the general population of Saudi Arabia towards health information sought from Twitter. Of the 384 total respondents, 199 (51.8%) considered using Twitter as a source of health information as a positive experience due to its ease of use and the accessibility of information (131, 66.0%). The study found that respondents have great concern about nutrition/weight loss (229, 59.6%), healthy lifestyle (225, 58.6%), and getting a better understanding of health care misconceptions (168, 43%). Most of the respondents (167, 43.5%) were satisfied using Twitter as a source of health information. However, a few respondents experienced harm to their health as a result of false medical advice (2, 0.5%) and false health information (2, 0.5%) they found on Twitter. This study concludes that Twitter is mainly useful in obtaining health knowledge for maintaining good health, preventing illness, and curing illnesses or diseases. However, the public must take extra caution when obtaining health information from Twitter. It is essential for Twitter users seeking medical information to also seek professional medical advice or consultation, as necessary, to prevent a significant health risk.

Use of Social Mobilization and Community Mobilizers by Non-governmental Health Organizations in Malawi to Support the Eradication of Polio, Improve Routine Immunization Coverage, and Control Measles and Neonatal Tetanus.

.Seventy-five percent of children aged 12–23 months in Malawi have received all eight basic vaccinations—still leaving many children at risk. The Malawi Expanded Program on Immunization comprehensive Multi-Year Plan 2016–2020 reveals several challenges impeding immunization and disease surveillance efforts, such as the fact that non-governmental health organizations (NGHOs) and communities are minimally included in the planning, implementation, and monitoring of these activities. This article examines the extent to which NGHOs are promoting the use of social mobilization (SM) and community mobilizers (CMs) for sharing health information related to the eradication of polio, the importance of routine immunization, and the control of measles and neonatal tetanus. Data collection involved document analysis and interviews with 11 organizations in Malawi whose work contributes to the eradication of polio and control of measles and neonatal tetanus. Content analysis was used to analyze the qualitative data, whereas descriptive statistics were used to analyze the quantitative data. Non-governmental health organizations use a variety of approaches for SM, including mass media campaigns (radio and printed booklets), local skits and dramas, and home visits. Most NGHOs use training workshops and opinion leaders to impart knowledge and skills to CMs on immunization to eradicate polio and to control measles and neonatal tetanus. Major challenges faced by the NGHOs include negative attitudes toward campaigns and demotivation of CMs due to lack of financial incentives. The article concludes with a discussion of approaches to strengthen SM and the role of CMs by NGHOs.