Source Of Health-related Information Research Articles

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.

Access to colorectal cancer screening for Pakistani immigrants in Norway – a qualitative study

BackgroundThe Norwegian colorectal cancer (CRC) screening program started in May 2022. Inequalities in CRC screening participation are a challenge, and we expect that certain groups, such as immigrants, are at risk of non-participation. Prior to the start of the national screening program, a pilot study showed lower participation rates in CRC screening among immigrants from Pakistan. These immigrants are a populous group with a long history in Norway and yet have a relatively low participation rate also in other cancer screening programs. The purpose of this study was to identify and explore perspectives and factors influencing CRC screening participation among immigrants from Pakistan in Norway.Materials and methodsIn this study we used a qualitative study design and conducted 12 individual interviews with Pakistani immigrants aged between 50 and 65 years. The participants varied in terms of gender, age, education, work, residence time in Norway and familiarity with the Norwegian language and culture. We performed thematic analysis with health literacy as a theoretical framework to understand Pakistani immigrants’ perspectives on CRC screening.ResultsWe identified four main themes: Health-related knowledge, the health care system, screening, and social factors. Within these themes we identified several factors that affect Pakistani immigrants’ accessibility to CRC screening. These factors included knowledge of the causes and development of cancer, sources of health-related information, the general practitioner’s role, understanding of screening and the intention behind it, language skills and religious beliefs.ConclusionThere are many factors influencing Pakistani immigrants’ decision of participation in CRC screening. The roles of the general practitioner and adult children are particularly important. Key elements to improve accessibility to CRC screening and enable informed participation for Pakistani immigrants are measures that improve personal and organizational health literacy.

Development of a User-friendly Health Promotion Website to Spread Evidence-based Information in Italy.

Appropriate communication models and strategies are crucial in order to strengthen preventive and health promotion interventions via digital platforms. Today, 52.23% of the Italian population use the Internet as a source of health-related information. The aim of the "Insegna Salute" project was to create a website that would enable people to satisfy their knowledge health needs and increase their awareness in the field of prevention. To develop the website, a qualitative literature research was carried out to collect an overview of effective online health communication strategies and tools before, during and after the COVID-19 pandemic. Further, we implemented the website insegnasalute.it according to the one-to-many (screen-to-face) communication model. The second part of the research focused on identifying tools to ensure the constant update of the platform. Finally, we proceeded with the creation of the visual identity. The research resulted in 28 sources regarding health communication, vaccine hesitancy, online health information seeking, visual identity, current digital and social trends and mis/disinformation. Many publications reported that healthcare professionals (HCPs) are the main providers of evidence-based information and the most effective agents against misinformation. Furthermore, most of the articles advocated the use of digital technologies, such as social media and websites, along with proactive and targeted communication strategies. Vaccination hesitancy and other health prevention issues require accurate tools to build trust-based relationships between users and healthcare professionals. In line with the preventive guidelines issued by the Italian Ministry of Health, new tools, such as "Insegna Salute", integrate health knowledge with communication strategies. In the wake of the COVID-19 pandemic, preventive measures are essential to protect the population from misinformation spread and the probability of getting ill.

Quality evaluation of internet resources related to breast surgery in major search engines in Korea

Background With the increasing number of internet users, search engines have become a widely used source of health-related information. However, evaluating the quality of medical information obtained through search engines can be challenging. This study aimed to evaluate the quality of search results related to breast implants obtained from major domestic websites in Korea using systematic evaluation standards.Methods Two main primary search terms (“gaseum” [breast] implant and “yubang” [breast] implant), along with 15 adjunct search terms, were combined and searched in Google, Naver, and Daum. The top 20 websites were evaluated and classified according to their type and provider. They were scored using the Korean Medical Association’s Internet Health Information Certification Standards. The proportion of significant websites, their categorical distribution, and the quality of information scores were then compared.Results Google yielded the highest number of appropriate results, with statistical significance. Blogs (36.4%) and news (34.8%) were the most common types of search results, while healthcare provider groups (49.5%) constituted the most common provider subgroup. Only 1.9% of the search results were from public organizations. Google had a significantly higher average quality score (14.04) than Naver (13.22), and Daum (12.45) (P<0.05).Conclusions Although almost half of the search results were provided by medical personnel, their average quality score (13.16) was below the overall average (13.36) and far below the 21 points of the journal/abstract category. The findings highlight the need for healthcare providers to provide high-quality medical information, and for users to develop high-level digital health literacy.

Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study.

Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known. We thus aimed to expand the existing base of scientific knowledge, focusing on this special population. Data were from the qualitative component of "the CAMPUS study", longitudinally assessing the mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts using the framework approach. An explanatory model was derived from five themes identified across 33 interviews (15 for Italy, 18 for the UK). Students perceived that social media, apps, and podcasts could deliver relevant mental health content, ranging from primary to tertiary prevention. Wide availability and anonymity were perceived as advantages that make tools suitable for preventive interventions, to reduce mental health stigma, and as an extension of standard treatment. These goals can be hindered by disadvantages, namely lower efficacy compared to face-to-face contact, lack of personalisation, and problematic engagement. Individual and cultural specificities might influence awareness and perspectives on the use of digital technologies for mental health support. Although considering some specific features, digital tools could be a useful instrument to support the mental health needs of students. Since personal contact remains crucial, digital tools should be integrated with face-to-face interventions through a multi-modal approach.

Critical evaluation of YouTube videos regarding the all-on-4 dental implant treatment concept: A content-quality analysis

Statement of problemRehabilitation of complete edentulous arches by using the all-on-4 dental implant treatment concept is a well-established procedure. Considering the popularity of YouTube as a source for health-related information, a thorough investigation of the content-quality and reliability of videos regarding the all-on-4 concept is lacking. PurposeThe purpose of this cross-sectional analysis was to critically appraise the content-quality and reliability of YouTube videos regarding the all-on-4 dental implant treatment concept as a source of information for patients, students, and dentists. Material and methodsA comprehensive search was performed on the YouTube website using the specific keyword “All-on-4,” which was identified as the most appropriate search term by the Google Trends website. Only English language videos regarding the all-on-4 dental implant treatment concept were included for systematic analyses. Following the eligibility criteria, the included videos were assessed for their demographic characteristics and quality-content. Based on the content score, the videos were categorized as low content (LC) and moderate + high content (MHC) groups. Further, qualitative analyses were performed by using the DISCERN tool and a global quality (GQ) scale. Statistical analyses were conducted by using the Mann-Whitney U test and the Spearman correlation analysis (α=.05). ResultsOf 250 screened videos, only 73 were eligible for final analyses. The included videos presented an average 123 846 (range, 4 to 3 182 404) views with a mean duration of 528 (range, 12 to 1699) seconds. In addition, the average number of likes was 1122 (range, 0 to 3300), but, remarkably, none of the included videos received any dislikes. Overall, the mean content-quality score was 6.2 ±3.8, thus indicating low-quality content. The average DISCERN and GQ scores were 47.73 ±9.94 and 3.41 ±0.95, with the Spearman rank correlation test showing a strong positive correlation (r=.732; P<.001) among the total obtained scores. Moreover, statistically significant differences were reported between the LC and MHC groups for both DISCERN and GQ scores (P<.001). ConclusionsThe reliability of YouTube videos regarding the all-on-4 dental implant treatment concept is questionable, as they exhibit poor content-quality, thus making them an unreliable source for patients, students, and dentists seeking accurate information.

A survey-based assessment of internet and social media use by oncology patients and their caregivers for health-related education.

321 Background: Oncology patients are increasingly utilizing the internet and social media (SM) as sources of health-related information. Contemporary information on oncology patient use patterns for health-related education is not well understood. To address this gap, we surveyed adult oncology patients on active treatment seen in a community-based oncology clinic about their use of the internet and SM around cancer-specific content. Methods: We conducted a qualitative, cross-sectional anonymous survey to understand the range of values, perspectives, and behaviors that patients and caregivers have around their use of internet and SM resources. We also assessed patient beliefs regarding the quality of education provided by their oncologists and how this may relate their patterns of use of these resources. Results: Of the 40 patients surveyed: 55% were male, 64% identified as Caucasian, 22% Latino, 14% were of other races, and 81% spoke English as their primary language. The group represented a diverse age range and education level and a variety of solid and hematologic malignancies. Most participants (89%) reported receiving written educational materials by their oncologist and 58% reported receiving links to electronic/internet resources for disease education.The vast majority of patients (95%) had a positive opinion of in-person education provided by their oncologist and 75% were satisfied with the quality of written or online resources provided. The majority of patients (85%) reported using the internet to learn about their diagnosis and treatment. A smaller proportion (43%) of patients used SM platforms. Of internet information sources used, the patient’s own health system website was the most popular choice (41.7%). Interestingly, 87% found resources without specific guidance from their oncologist. Notably, 11% of patients were instructed by their oncologist to avoid researching their diagnosis online. Conclusions: Our research shows that internet and SM use among patients with cancer is ubiquitous, and independent of the educational interventions provided by their oncologists. Importantly, 66% of participants felt that online research helped them feel more prepared for discussions with their oncologists. A quarter (25%) of patients agreed that they only use online resources recommended by their oncologist’s office, suggesting that the majority of patients will pursue their own research in a self-guided fashion. Encouragingly, the majority of patients (86%) reported that they feel comfortable discussing information they find online with their care provider. Improved understanding in this area will help oncologists better guide their patients to reliable resources and engage more directly in the patient or caregiver’s process of seeking cancer-specific information from outside sources.

What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe?

In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe, with Eastern European countries in particular facing very high levels of vaccine hesitancy and refusal. This study investigates the determinants of COVID-19 vaccine hesitancy and refusal, with a focus on these differences across Eastern, Southern and Western Europe. The statistical analyses are based on individual-level survey data comprising quota-based representative samples from 27 European countries from May 2021. The study finds that demographic variables have complex associations with vaccine hesitancy and refusal. The relationships with age and education are non-linear. Trust in different sources of health-related information has significant associations as well, with people who trust the Internet, social networks and 'people around' in particular being much more likely to express vaccine skepticism. Beliefs in the safety and effectiveness of vaccines have large predictive power. Importantly, this study shows that the associations of demographic, belief-related and other individual-level factors with vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Eastern, Southern and Eastern Europe need to focus on why levels of trust and vaccine-relevant beliefs differ across regions, because the effects of these variables appear to be similar. It is the much higher prevalence of factors such as distrust of national governments and medical processionals as sources of relevant medical information in Eastern Europe that are relevant for explaining the higher levels of vaccine skepticism observed in that region.

Changes in information-seeking patterns and perception of health crisis management in a year of COVID-19 pandemic: a repeated cross-sectional study

To assess the changes in the health information search patterns related to the COVID-19 pandemic and the use of this information in Croatia.This repeated cross-sectional study was based on an online survey among adults in Croatia from June 5 to July 5 2020 and from May 25 to June 15 2021. The survey inquired about demographic characteristics, health information search patterns, and emotional reactions to health information. The differences between the year 2020 and the year 2021 were assessed.The survey was completed by 569 respondents (median age 38.5 years) in 2020 and by 598 respondents (median age 40 years) in 2021. In 2020, institutional governmental bodies were perceived to be a reliable source of information, but this perception declined in 2021. Whereas in 2020 TV was the most used source of health-related information, online media prevailed in 2021. After one year of the pandemic, respondents attributed significantly greater importance to the reliability of the information obtained from different sources.Our results may be valuable in designing public health communication strategies and campaigns, in selecting communication channels and sources, and in tailoring health information according to the characteristics and habits of the studied population.

Formative Research on HPV Vaccine Acceptance among Health Workers, Teachers, Parents, and Social Influencers in Uzbekistan.

Human papillomavirus (HPV) vaccines effectively prevent cervical cancer, most of which results from undetected long-term HPV infection. HPV vaccine introduction is particularly sensitive and complicated given widespread misinformation and vaccination of young girls before their sexual debut. Research has examined HPV vaccine introduction in lower- and middle-income countries (LMICs), but almost no studies attend to HPV vaccine attitudes in central Asian countries. This article describes the results of a qualitative formative research study to develop an HPV vaccine introduction communication plan in Uzbekistan. Data collection and analysis were designed using the Capability, Opportunity, and Motivation for Behaviour change (COM-B) mode for understanding health behaviours. This research was carried out with health workers, parents, grandparents, teachers, and other social influencers in urban, semi-urban, and rural sites. Information was collected using focus group discussions (FGDs) and semi-structured in-depth interviews (IDIs), and data in the form of participants' words, statements, and ideas were thematically analysed to identify COM-B barriers and drivers for each target group's HPV vaccine-related behaviour. Represented through exemplary quotations, findings were used to inform the development of the HPV vaccine introduction communication plan. Capability findings indicated that participants understood cervical cancer was a national health issue, but HPV and HPV vaccine knowledge was limited among non-health professionals, some nurses, and rural health workers. Results on an opportunity for accepting the HPV vaccine showed most participants would do so if they had access to credible information on vaccine safety and evidence. Regarding motivation, all participant groups voiced concern about the potential effects on young girls' future fertility. Echoing global research, the study results highlighted that trust in health workers and the government as health-related information sources and collaboration among schools, municipalities, and polyclinics could support potential vaccine acceptance and uptake. Resource constraints precluded including vaccine target-aged girls in research and additional field sites. Participants represented diverse social and economic backgrounds reflective of the country context, and the communication plan developed using research insights contributed to the Ministry of Health (MoH) of the Republic of Uzbekistan HPV vaccine introduction efforts that saw high first dose uptake.

Young adults searching for Health-Related Information on the Internet

This study aimed to examine the use of internet as a source of health-related information (HRI), as well as the change in attitudes following the online search for HRI. The current study sample included 88 participants, randomly divided into two experimental groups. One was given the name of an unfamiliar disease and told to search for information about it using various search engines, and the second was given a text about the disease from a credible scientific source. The study findings show a large percentage of participants used the internet as a source of HRI. Likewise, no differences were found in the extent to which the internet was used as a source of HRI when demographic were compared. Those who searched for the HRI on the internet had more negative opinions and believed symptoms of the disease were worse than the average opinion among those who obtained the information about the disease from a credible scientific source. Internet clearly influences the participants’ beliefs, regardless of demographic differences.

Mums Go Online: Is the Internet Changing the Demand for Health Care?

Abstract We study the effect of Internet diffusion on childbirth procedures performed in England between 2000 and 2011. We show that broadband Internet access increased cesarean sections (C-sections): mothers living in areas with better Internet access are 2.5% more likely to obtain a C-section. The effect is driven by first-time mothers who are 6% more likely to obtain a C-section. The increased C-section rate is not accompanied by changes in health care outcomes; thus health care costs increased with no corresponding medical benefits. We show evidence documenting the growing importance of the Internet as a source of health-related information.

The Relationship Between Information Sources, Health Literacy, and COVID-19 Knowledge in the COVID-19 Infodemic: Cross-sectional Online Study in Japan.

BackgroundThe COVID-19 pandemic has caused not only a disease epidemic but also an infodemic. Due to the increased use of the internet and social media, along with the development of communication technology, information has spread faster and farther during the COVID-19 infodemic. Moreover, the increased choice of information sources has made it more difficult to make sound decisions regarding information. Although social media is the most common source of misinformation, other forms of media can also spread misinformation. However, the media sources used by people with high health literacy and COVID-19 knowledge to obtain information are unclear. Furthermore, the association between the use of multiple information sources and health literacy or COVID-19 knowledge is ill-defined.ObjectiveThis study aims to examine the following 3 aspects regarding the COVID-19 infodemic: (1) the relationship between health literacy, COVID-19 knowledge, and the number of information sources used; (2) the impact of media use on health literacy; and (3) the impact of media use on COVID-19 knowledge.MethodsAn online cross-sectional study was conducted in November 2021. Participants were 477 individuals aged 20-69 years. After obtaining consent to participate in the study, participants were asked about sociodemographic indicators, sources of health-related information, health literacy, and COVID-19 knowledge. Sources of health-related information were categorized into 4 types: mass media, digital media, social media, and face-to-face communication. The Spearman rank correlation test was conducted to determine the relationship between health literacy, the number of correct answers to COVID-19 knowledge, and the number of information sources used. Multiple regression analysis was conducted with health literacy and the number of correct answers as dependent variables, the 4 media types as independent variables, and age and sex as adjustment variables.ResultsMass media was the most frequently used source of information, followed by digital media, face-to-face communication, and social media. Social media use was significantly higher among individuals aged 20-29 years than among other age groups. Significant positive correlations were found between health literacy, the number of positive responses to COVID-19 knowledge, and the number of information sources used. Multiple linear regression analysis showed that health literacy is associated with access to information from digital media and face-to-face communication. Additionally, COVID-19 knowledge was associated with access to information from mass media, digital media, and face-to-face communication.ConclusionsHealth literacy and COVID-19 knowledge could be improved using diverse information sources, especially by providing opportunities to use digital media and face-to-face communication. Furthermore, it may be important to improve health literacy and provide accurate knowledge about COVID-19 to young adults.

Sleep Quality in Relation with Cyberchondria Among Young Adults During COVID-19 Pandemic

According to the United Nations third sustainable development goal, ensuring healthy lives and promoting the well-being of all at all ages is essential. Currently, COVID-19 pandemic is the defining global health crisis and causing considerable psychological and physical distress as well as high mortality rates across the world. Recently, the internet has rapidly become the major source of health related information among the general public. This behavior of searching the internet for the common symptoms has increased during this pandemic due to the fear of uncertainty. However, the excessive and compulsive use of the internet for health information leads to a phenomenon termed as cyberchondria. It is defined as an increase in anxiety about one’s own health status as a result of excessive online searches. The increase in anxiety and distress has an impact in the sleep quality among individuals. Hence, the present study aims to focus on cyberchondria during the COVID-19 pandemic and how it is affecting the sleep quality among young adults. Simple random sampling technique has been administered to collect the data. Participants (N=123) responded to the Cyberchondria Severity Scale short-form (CSS-12), Sleep Quality scale (SQS-28), and the demographic data. Results revealed that all the four dimensions of cyberchondria and the overall score showed significant positive relationship with all other factors and overall score of sleep quality except the factor, difficulty getting up. Further, young adults having high level cyberchondria are highly responsible for more variance in sleep quality other than young adults having low level cyberchondria.

Health Literacy Needs Among Unemployed Persons: Collating Evidence Through Triangulation of Interview and Scoping Review Data.

BackgroundUnemployed persons are at high risk for low health literacy. Most studies addressing health literacy of unemployed persons focus on risk factors for low health literacy or correlates of health literacy, but studies on needs of unemployed persons regarding health literacy are scarce. We aimed to obtain better understanding of health literacy needs of unemployed adults by triangulating the results from a scoping review on health literacy needs in unemployed adults and additional in-depth qualitative interviews.MethodsScoping review: We searched six databases up to January 2021 as well as gray literature for relevant studies following PRISMA-ScR guidelines. Titles, abstracts, and full texts were screened independently by two researchers. Qualitative study: Ten participants of a job-reintegration program in Germany were interviewed following a guideline covering topics including health issues of interest to the participants, their sources of health-related information and the barriers/facilitators they experience when accessing health services.ResultsScoping review: After screening 2,966 titles and abstracts, 36 full texts were considered, and five articles fulfilled the inclusion criteria. Four focused on mental health literacy and outcomes, while the fifth assessed information-seeking practices. One additional report on health literacy was identified via the gray literature search. Awareness of one's condition was identified as a facilitator for mental health help-seeking, while fear of harmful effects of medication prevented help-seeking. Qualitative study: Participants were interested in and were generally well-informed about health topics such as nutrition and physical activity. The main challenge perceived was translating the knowledge into practice in daily life. GPs and the social services providers played an important role as a source of health information and advice. Regarding mental health, similar barriers, facilitators and needs were identified through triangulation of findings of the scoping review with those of the interviews.ConclusionsThere is need to address health literacy needs of long-term unemployed persons that go beyond mental health literacy. Public health interventions should not only aim at improving health literacy scores, but also focus on how to help participants translate health literacy into practice. Population groups of interest should also be involved in all processes of designing interventions.

Bangladesh health journalism: A pilot study exploring the nature and quality of newspaper health reporting

Introduction: The media is an important source of health-related information for patients, general public, policymakers and health professionals and has a large influence on their knowledge and opinions. No studies so far have explored the content, nature and quality of health journalism in Bangladesh. Objectives: To i) explore the nature and quality of media coverage of health stories in Bangladeshi newspapers, ii) understand the perceptions of reporters about medical- and health journalism, including the perceived barriers and facilitators, and iii) identify factors influencing health reporting. Methods: In a mixed-method pilot study, during a five-month period, all medical and healthcare related news articles published in three leading Bangladeshi daily newspapers (N=461), were content analyzed, and journalists were asked in a questionnaire about their knowledge and medical skills. Results: Only 44% of the articles reported in a positive tone on health services aspects, while 27.1% were related to malpractice or treatment errors. Many articles contained questionable medical information (49.9%), mostly regarding unregistered clinicians (67.5%), often referred to as ‘doctor’. Treatment errors by unregistered clinicians were reported seven times more often than those by registered physicians (p&lt;0.001). A survey was completed by 23 selected medical- or health journalists (77% response); most of them (78.3%) had no previous training in health journalism and in only 26.1% this was offered by their media house. Journalists self-reported their own insufficient understanding of medical terminology (73.9%), ethics (95.7%) and relevant laws (91.3%). Conclusion: This study is an eye opener about shortage of medical knowledge among health journalists in a developing country. This shortage may often result in misinformation regarding medical (mal)practice, health laws and ethics. There is ample room for improvement of the quality of health news reporting and health journalism skills in Bangladesh. N=287

Health literacy needs among unemployed adults: Triangulating interview and scoping review data

Abstract Disadvantaged populations, including unemployed adults, often exhibit low levels of health literacy. Exploring subjectively perceived health literacy needs in these populations can serve as an entry point for participatory intervention development. We aimed to assess health literacy needs of unemployed adults by triangulating qualitative interviews data and a scoping review. Using a parallel approach, we combined results of an interview study with 10 participants of a job-reintegration program in Germany and a scoping review. The interviews, conducted in early 2021, focused on health topics of interest to the participants and their sources of health-related information. Data were analysed using thematic analysis. For the scoping review, we searched MEDLINE, CINAHL, PsycInfo and SCOPUS up to January 2021 for studies containing “unemployed” AND “health literacy” in titles/abstracts. Study selection and data extraction were done independently by two researchers. Nutrition and physical activity emerged as core themes during the interviews, with some participants referring to the importance of both for mental health. Doctors and the institution running the job-reintegration program were the sources of health-related information often mentioned. The Corona pandemic was reported to have limited physical activity and affected psycho-social well-being. Five out of 2696 studies were included in the review. Four focused on mental health literacy, the fifth assessed information seeking practices in unemployed adults. The qualitative analysis revealed that health literacy needs of unemployed adults go beyond mental health literacy. As nutrition and physical activity impact mental health, interventions targeting such topics might also improve mental health literacy in unemployed adults. Study findings will be discussed with unemployed persons and social workers in co-production workshops that aim to identify and prioritize health literacy needs for intervention development. Key messages Health literacy programs for unemployed adults should target nutrition and physical activity. Workforce re-integration programs play a pivotal role in improving health literacy of unemployed adults.

Type ll Diabetic Patients’ Attitudes Toward Influenza and Covid-19 Vaccination

Influenza vaccination (fluv) is free and easily accessible to diabetics in Quebec. The importance of vaccination (v) during the Covid19 (CV19) pandemic has been widely discussed in the media. To ascertain the receptiveness of type 2 diabetics (T2D) to fluv during the CV19 pandemic and their acceptance of an eventual CV19 vaccine (CVv) we carried out telephone interviews with 34 unselected T2D pts in Montreal, Quebec post the 1st wave of CV19 in that region. Pts were asked if they planned taking the fluv and/or an eventual CVv, reasons for reticence to v, and attitudes toward and compliance with public health (PH) directives. They were also asked their primary source of health related information. Recent HbA1c and insulin use were recorded. Thirty four T2Ds were surveyed, 22 M 50–87 yrs (mean 69.2) and 12 F 49–84 yrs (mean 68.8). Eleven M and 5 F were on insulin. HbA1c ranged from 5.9–13.0 (mean 7.3). None of the pts had recently discussed v with a healthcare provider (HCP). One pt received his health related information from Facebook, the others from mainstream media. None had contraindications to v. None had been diagnosed with CV19. Past influenza history was unknown. Forty one percent (14/34) of pts, 11 M 50–86 yrs (mean 66.0) and 3 F 49–66 yrs (mean 59.0) did not plan to take the fluv. They explained their decisions as never having taken fluv (12 pts) or having been ill despite having taken it (2 pts). Neither accessibility nor cost were issues. Two F, 62 and 66 yrs, who refused fluv also refused CVv. Six M aged 60–86 yrs (mean 70.5) and 1 F aged 73 yrs were planning to wait to access real life safety (6pts) or efficacy (1pt) data before accepting CVv. All pts claimed to be following PH guidelines including social distancing, hand washing, and mask recommendations; 91.2% (31/34) fully agreed with PH policies, 2 were in moderate agreement and 1 thought PH policy was not strict enough. Of the latter 3 pts none planned on taking the fluv. One planned taking the CVv, 1 planned not to, and the 3rd planned to wait before deciding. Despite a long history of use, recommendations by experts, and free and easy accessibility, T2D pts questioned after the 1st wave of CV19 are not convinced of the fluv’s importance. Despite high case numbers and being themselves at high risk, not all T2Ds are willing to unequivocally accept a potential Health Canada sanctioned CVv. This study underlines the important work HCPs have ahead in educating and reassuring pts with regard to vaccination.

The Relationship Between Health Literacy Level and Media Used as a Source of Health-Related Information.

Background:Previous studies have not shown the level of health literacy or associated factors on a national level in Turkey using a scale that has been adapted to the country and its culture.Objective:This study aimed to determine health literacy levels in Turkey and to investigate the association of health literacy with socioeconomic factors as well as with the instruments used as sources of health-related information.Methods:This cross-sectional, nationally representative study was conducted using a computer-assisted personal interview approach and included 6,228 households (response rate, 70.9%). The Turkey Health Literacy Scale was used to measure health literacy. Sources of health-related information, such as newspapers, television, internet, and smartphones, were included in the regression model for health literacy.Key Results:The proportion of participants with inadequate and problematic health literacy was 30.9% and 38%, respectively, showing that approximately 7 of 10 participants had limited health literacy. The frequencies of inadequate and problematic health literacy were higher in the disease prevention and promotion domains (37.4% and 34.2%, respectively) compared with those in the health care domain (27.1% and 31.3%, respectively). The most frequently used medium as a source of health-related information was the internet (48.6%), followed by television (33%). In controlled models, higher health literacy scores were associated with higher education and income levels. The effects of television (β = 1,917), internet (β = 2,803), newspapers (β = 1,489), and smartphones (β = 1,974) as sources of health-related information were statistically significant in the general health literacy index model.Conclusions:Health literacy in Turkey reflects social inequalities. The model accounting for socioeconomic variables demonstrated the relevance of sources of health information to level of health literacy. These findings emphasize the importance of improving sources of health information to improve health literacy. [HLRP: Health Literacy Research and Practice. 2021;5(2):e109–e117.]Plain Language Summary:This is a cross-sectional study that is representative of the population of Turkey. We reported that health literacy scores were higher for people in higher levels of socioeconomic status. We showed that using the television, internet, newspapers, and smartphones as a source of health-related information is associated with health literacy even when accounting for socioeconomic variables.

YouTube for information about side effects of biologic therapy: A social media analysis.

Biologic therapies are one of the most significant breakthroughs in the treatment of rheumatic diseases, although there is still some uncertainty surrounding long-term patient safety. Recently, a growing number of patients browse the Internet as a source of health-related information. We aimed to assess the quality of information available on YouTube videos regarding the side effects of biologic therapy. We used the keywords "biologic therapy side effects," "biologic therapy risks," "biologic therapy safety," "biologic agents side effects," "biologic agents risks," and "biologic agents safety." Also, the generic and commercial names of biologic agents were searched on YouTube in May 2020. The quality and reliability of the videos was assessed according to the global quality score (GQS), DISCERN score. Video Power Index (VPI) used to assess both the view and the like ratios of the videos. Seventy-five videos were evaluated. According to the GQS, 31 videos (40.3%) were of high quality, 18 videos (23.4%) were of intermediate quality, and 28 videos (36.4%) were of low quality. The GQS was significantly positively correlated with the DISCERN score (P<.001). VPI scores were not correlated with DISCERN (P=.268) and GQS scores (P=.411). YouTube videos on the side effects of biologic therapy are informative for patients and physicians. High-quality videos are more reliable but may not be as popular as expected.