Web-based Video Research Articles

Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for I-COPE study

BackgroundOlder adults with chronic pain, opioid use, and opioid use disorder (OUD) present complex management decisions in primary care. Clinical tools are needed to improve care delivery. This study protocol describes the planned implementation and evaluation of I-COPE (Improving Chicago Older Adult Opioid and Pain Management through Patient-centered Clinical Decision Support and Project ECHO®) to improve care for this population.MethodsThis study uses a pragmatic, expanding cohort stepped-wedge design to assess the outcomes. The study will be implemented in 35 clinical sites across metropolitan Chicago for patients aged ≥ 65 with chronic pain, opioid use, or OUD who receive primary care at one of the clinics. I-COPE includes the integration of patient-reported data on symptoms and preferences, clinical decision support tools, and a shared decision-making tool into routine primary care for more effective management of chronic pain, opioid prescribing, and OUD in older adults. Primary care providers will be trained through web-based videos and an optional Project ECHO® course, entitled “Pain Management and OUD in Older Adults.” The RE-AIM framework will be used to assess the I-COPE implementation. Effectiveness outcomes will include an increased variety of recommended pain treatments, decreased prescriptions of higher-risk pain treatments, and decreased patient pain scores. All outcomes will be evaluated 6 and 12 months after implementation. PCPs participating in Project ECHO® will be evaluated on changes in knowledge, attitudes, and self-efficacy using pre- and post-course surveys.DiscussionThis study will provide evidence about the effectiveness of collecting patient-reported data on symptoms and treatment preferences and providing clinical decision support and shared decision-making tools to improve management for older adults with chronic pain, opioid use, and OUD.Trial registrationClinicalTrials.gov NCT04878562.

Feasibility and Acceptability of Recruitment and Retention in a Remote Trial of Gatekeeper Training for Military Veterans

Background SAVE (Signs; Ask; Validate; Encourage) is a brief gatekeeper training designed to teach lay individuals how to identify and assist military veterans at risk for suicide. SAVE can be delivered asynchronously using a web-based video format, but no studies of the effectiveness of SAVE exist. Objective The aim of this project was to determine the feasibility and acceptability of recruitment and retention in a remote trial of SAVE. Methods We conducted a social media campaign using sponsored Facebook posts (ads) to recruit veterans, including those outside the Veterans Affairs network of care, and their loved ones. Participants (N=214) were randomized to SAVE or a sham video training unrelated to suicide prevention and followed for 6 months. We also conducted qualitative interviews with a subgroup (n=15) and used a mixed methods framework to integrate findings. Results At baseline, most participants were a family member or friend of a veteran (146/214, 68.2%), and 47.7% (102/214) knew at least one veteran or service member who had died by suicide. Across both study arms, 73.8% (158/214) responded to at least 3 of 6 follow-up surveys and 72.4% (155/214) completed follow-up at 6 months. Themes from interviews indicated the following three barriers to study participation: generic posts, copy (ad text) referring to “research,” and Facebook as a platform. There were 5 facilitators to participation: audience segmentation focused on veterans’ family members and friends, an urgent call to action to help a veteran, prior exposure to suicide, emphasizing the benefits of receiving training, and using a university as the campaign messenger. Conclusions A social media campaign was a feasible and acceptable approach to recruiting and retaining participants—especially the loved ones of veterans with prior exposure to suicide—for a fully remote trial of SAVE gatekeeper training. Several campaign strategies may be applied to further promote remote study participation in this population. Trial Registration ClinicalTrials.gov NCT04565951; https://clinicaltrials.gov/ct2/show/NCT04565951 Conflicts of Interest None declared.

The use of simple web-based animation videos to improve engagement and understanding of quality improvement basics for trainee doctors

The use of simple web-based animation videos to improve engagement and understanding of quality improvement basics for trainee doctors

Web Based Video Conference Application for Online Learning Media

The COVID-19 pandemic has created the need for online learning activities at schools and universities. The use of the video conference application itself is one of the most important alternatives to traditional learning activities. According to researchers, the main issues are the high cost of existing applications and the limitation of access devices. There are three main phases in developing this application: server preparation, application development, and implementation. This application was developed using WebRTC, Jitsi JICOFO, Prosody XMPP server, and Nginx web server. The technical maturity of this study is two, the construction of this application is practical, and the examples are limited to the study and speculative. The purpose of this study is to create a web-based video conferencing application that can be accessed from anywhere without logging in with a web browser alone, has a limited time, and can be attended by over 100 users.

Virtual Reality Simulated Learning Environments: A Strategy to Teach Interprofessional Students About Social Determinants of Health.

Physician assistants (PAs) and medical degree students (MDs) often lack training in addressing the social determinants of health (SDOH). Social work students (SWs), meanwhile, have extensive SDOH training; however, few medical professionals have opportunities to engage in interprofessional training with SWs. This study examined the feasibility, acceptability, and students' perceptions of an interprofessional virtual reality (VR) simulated learning environment (SLE) for teaching health professions students about the SDOH. In January 2020, 15 students at Boston University School of Medicine attended web-based video conferences focused on SDOH, health equity, and team-based care. Subsequently, student dyads participated in a case-based learning activity using an immersive VR SLE to develop teamwork skills. Evaluation included a postsurvey and a focus group examining their experiences in the course to gauge feasibility and acceptability. Thematic analysis of open-ended survey responses from the postsurvey and focus group data was conducted. A total of 8 VR simulations were run. Findings indicated both MD and PA students learned patient engagement strategies from SW students, who enhanced their health care leadership capacity. Participants found the means of instruction acceptable, valued the hands-on VR interprofessional training, and expressed interest in learning more about the scope of one another's roles and the community resources available to patients. VR SLE is a feasible and acceptable means of instruction. It allowed students to connect across programmatic and geographic boundaries in a collaborative working environment mimicking the team approach to care they will use in their professional life. This experience illustrated for students the strengths a multidisciplinary team has to offer.

Long-term Outcomes of Behavior Therapy for Youth With Tourette Disorder.

To determine the long-term durability of behavior therapy for tics among youth with Tourette disorder and persistent (chronic) motor or vocal tic disorders. Of the 126 youth who participated in a randomized controlled trial of behavior therapy 11 years prior, 80 were recruited for this longitudinal follow-up. Consenting participants were interviewed in person or remotely (Web-based video) by trained evaluators to determine the course of tics, current tic severity, and tic-related impairment. Recruitment and data collection occurred between 2014 and 2019, with an average follow-up duration of 11.2 years. Treatment responders to both conditions in the original trial achieved partial, but not full, tic remission. Tic severity also decreased significantly across the sample, with 40% reporting partial remission. Behavior therapy responders (n= 21) in the original trial were more likely (67%) to achieve remission at follow-up (Total Tic Score= 12.52, SD= 10.75) compared to psychoeducation/supportive therapy responders (n= 6, 0%) at follow-up (Total Tic Score= 20.67, SD= 6.92) on the Yale Global Tic Severity Scale. Tic-related impairment decreased across the sample, with no significant differences between treatment groups or responders. Despite limitations of unmeasured variables and veracity of self-report at follow-up, this study supports guidelines recommending behavior therapy as the first-line intervention for tics. Further investigation of behavior therapy as an early preventive intervention also merits attention.

Study Protocol for Surveying Nutrient Assessment With Photographs of Meals (SNAPMe): A Benchmark Dataset of Food Records and Paired With Meal Photos

ObjectivesPhoto-based dietary assessment methods are becoming more feasible as artificial intelligence methods improve. However, advancement of these methods to the level usable in nutrition studies has been hindered by the lack of a dataset against which to benchmark algorithm performance. Here, we introduce the Surveying Nutrient Assessment with Photographs of Meals (SNAPMe) Study (ClinicalTrials ID: NCT05008653), describe the data, and discuss the utility of the data. MethodsThe purpose of the SNAPMe Study was to pair meal photographs with traditional food records. The goal was to collect approximately 1000 real-world meal photos from 100 participants consuming at least three meals per day, for a total of three study days. Participants were recruited nationally and completed enrollment meetings via web-based video conferencing. Participants uploaded and annotated their meal photos using a mobile phone app called Bitesnap and completed food records using the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24®) on the same day. A sizing marker with black and white boxes of known size were included in meal photos to assist with portion estimation. Participants included photos before and after eating non-packaged and multi-serving packaged meals, as well as photos of the front package label and ingredient label for single-serving packaged foods. ResultsBy the end of the study, 90 participants had completed all three days of data collection. Examples showing the utility of SNAPMe data with respect to artificial intelligence will be presented. ConclusionsThe SNAPMe dataset will be made publicly available and will link meal photos, annotations, write-in notes, and ASA24 food records together. These data will be transformative for the improvement of artificial intelligence algorithms for the adoption of photo-based dietary assessment in nutrition research. Funding SourcesThis work was supported by the United States Department of Agriculture (USDA)/NSF AI Institute for Next Generation Food Systems (AIFS), USDA award number 2020-67,021-32,855.

A 3‐D approach to personalised nutrition

A <scp>3‐D</scp> approach to personalised nutrition

Evolution of Web-Based Training Videos Provided by the German Respiratory League for the Correct Inhalation Technique

Background/Objective: To assess whether and how the use of scientifically established Web-based training videos for teaching correct inhalation technique in patients with chronic airway diseases has become accepted among the wider population. Methods: The viewing trends of 141 freely available YouTube videos (full playing time, 01:31–04:37 min:s) provided by the German Respiratory League, covering a broad range of internationally prescribed devices, were analyzed over a 10-year period. Specific emphasis was placed both on German and international videos. Results: The total number of views was 3,350,678. Non-German videos (English, Russian, Turkish, Greek, Arabic, Farsi, and Slovakian) accounted for 23.2% of the views. The number of views steadily increased between 2011 and 2020 with a mean annual increase of 54.0% (range 24.5/119.9%) compared to the respective previous year. By 2020, the incidence of views per 100,000 German inhabitants was 725 for German videos only and 1,030 for all videos. In terms of the annual trend, there were two peak viewing periods, namely in spring and late fall, while the lowest amount of views occurred in summer. Conclusion: This study highlights the rising impact of Web-based training videos used for teaching the correct use of inhalation devices, with a steady increase in the number of annual views and a clear seasonal peaking of views in spring and late fall.

Radiology trainee and attending satisfaction with virtual readouts during the COVID-19 pandemic

Rationale and objectivesIn response to COVID-19, our institution implemented three virtual readout systems: a commercial HIPAA compliant web-based video conferencing platform used for screen-sharing (Starleaf), an interactive control sharing system integrated into PACS allowing simultaneous multi-user mouse control over images (Collaborate), and the telephone. Our aim was to assess overall satisfaction with and perceived effectiveness of these virtual readout methods to optimize best practices for the future. Materials and methodsAn IRB-exempt survey was electronically distributed to 64 trainees and 76 attendings at one tertiary-care institution via Survey Monkey. Questions focused on overall satisfaction, perceived effectiveness, technical difficulties, and continued future use of the three virtual readout strategies. Answers were collected with Likert scales, tick boxes, and open-ended questions. Results32/64 trainees (50%) and 32/76 attendings (42%) completed the survey. Trainees and attendings were more satisfied with screen sharing (Starleaf) and perceived it more effective than control sharing (Collaborate) or the telephone (p < 0.0001). Respondents experienced more technical difficulties with control sharing versus screen sharing (p = 0.0004) with a negative correlation between level of technical difficulties and satisfaction with screen sharing (r = −0.50, p < 0.0001) and control sharing (r = −0.38, p = 0.0006). Trainees and faculty supported a combination of in-person and virtual readouts in the future (p < 0.0001). ConclusionPlatforms mirroring in-person readouts, such as Starleaf, are preferred by both trainees and attendings over non-screen sharing platforms such as the telephone. However, technical stability determines satisfaction between similar platforms. Both trainees and attendings support incorporation of virtual readout methods in combination with traditional in-person readouts in the post-COVID-19 era.

Evaluation of the Effect of Patient Education and Strengthening Exercise Therapy Using a Mobile Messaging App on Work Productivity in Japanese Patients With Chronic Low Back Pain: Open-Label, Randomized, Parallel-Group Trial.

BackgroundArtificial intelligence–assisted interactive health promotion systems are useful tools for the management of musculoskeletal conditions.ObjectiveThis study aimed to explore the effects of web-based video patient education and strengthening exercise therapy, using a mobile messaging app, on work productivity and pain in patients with chronic low back pain (CLBP) receiving pharmacological treatment.MethodsPatients with CLBP were randomly allocated to either the exercise group, who received education and exercise therapy using a mobile messaging app, or the conventional group. For patient education, a web-based video program was used to provide evidence-based thinking regarding the importance of a cognitive behavioral approach for CLBP. The exercise therapy was developed in accordance with the recommendations for alignment, core muscles, and endogenous activation, including improvement of posture and mobility for proper alignment, stimulation and/or strengthening of deep muscles for spinal stability, and operation of intrinsic pain for the activation of endogenous substances by aerobic exercise. Both groups continued to receive the usual medical care with pharmacological treatment. The end points were changes in work productivity, pain intensity, quality of life, fear of movement, and depression. The observation period for this study was 12 weeks. An analysis adjusted for baseline values, age at the time of consent acquisition, sex, and willingness to strengthen the exercise therapy was performed.ResultsThe exercise and conventional groups included 48 and 51 patients, with a mean age of 47.9 years (SD 10.2 years; n=27, 56.3% male patients) and 46.9 years (SD 12.3 years; n=28, 54.9% male patients) in the full analysis set, respectively. No significant impact of these interventions on work productivity was observed in the exercise group compared with the conventional group (primary end point: Quantity and Quality method; 0.062 vs 0.114; difference between groups −0.053, 95% CI −0.184 to 0.079; P=.43). However, the exercise group showed consistently better trends for the other end points than did the conventional group. Compared with the conventional group, the exercise group showed a significant improvement in the symptoms of low back pain (3.2 vs 3.8; difference between groups −0.5, 95% CI −1.1 to 0.0; P=.04), quality of life (EuroQoL 5 Dimensions 5 Level: 0.068 vs 0.006; difference between groups 0.061, 95% CI 0.008 to 0.114; P=.03), and fear of movement at week 12 (−2.3 vs 0.5; difference between groups −2.8, 95% CI −5.5 to −0.1; P=.04).ConclusionsThis study suggests that patient education and strengthening exercise therapy using a mobile messaging app may be useful for treating CLBP. This study does not reveal the effect of therapeutic interventions on CLBP on work productivity. Thus, further research is required to assess work productivity with therapeutic interventions.Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry UMIN000041037; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046866

Effectiveness of alternative prenatal genetic counselling methods in a cohort of pregnant women from a low socio-economic population.

There are concerns about the capacity of healthcare providers to adequately counsel women on the implications of noninvasive prenatal screening (NIPS). Studies suggest that more resource-efficient counselling methods are needed for broad adoption. We prospectively examined the effectiveness of alternative methods of prenatal counselling on a patient's knowledge and understanding of prenatal testing choices, with a focus on NIPS. We also evaluated prenatal test choice and emotional well-being after making this decision. Women from a low socio-economic population were offered NIPS at no additional cost along with typical prenatal screening and diagnosis. Study participants underwent prenatal counselling via a web-based video consultation or a telephone consultation with a genetic counsellor. Participants were asked to complete pre-counselling and post-counselling questionnaires. Of 1000 women enrolled, 600 completed both surveys in full and were included in the analysis. Of these, 354 (59%) underwent counselling via a telephone consultation and 246 (41%) via the web-based video consultation. Both counselling methods led to a significant increase in patient knowledge (P < 0.01). NIPS uptake was equivalent between groups. Patients expressed a high level (90%) of satisfaction with their prenatal screen choice, with no significant difference (P > 0.10) between telephone and web participants. Alternative methods of counselling such as a web-based education portal can be highly effective and should be considered to enable informed decision-making prior to undergoing prenatal screening such as NIPS. Further, web-based education tools could be beneficial for those in rural areas with limited access to healthcare providers and non-native speakers.

P076 Innovative SMS based COVID-19 vaccination video advice: real-world evidence of the positive impact on vaccination uptake in a large single-centre cohort

Background/AimsThe UK coronavirus vaccination programme has been successful; by 8.10.21, 85% of those over 12 years had received the first dose of the vaccine and approximately 78% had received both doses. National guidance from British Society for Rheumatology recommends that all patients with rheumatic disease should receive a SARS-CoV-2 vaccine regardless of underlying diagnosis and treatment regime. Data highlight that in this group vaccine uptake can be significantly improved with physician recommendations and timely intervention. At the Royal Wolverhampton Trust (RWT, UK), we have previously described an innovative 8-minute web-based multimedia educational video sent via SMS-text messaging 21.12.20 to increase awareness of the recommendations and safety profile of the COVID vaccine in our cohort. A single-centre longitudinal study assessing the impact of COVID-19 on health-related quality of life (HRQOL) in our rheumatology patients is ongoing (NCT04542031), which we used to explore the impact of our intervention.MethodsExisting study participants were sent a 6-monthly SMS text message containing a linked web-based survey. This collects demographic profiles, including gender, ethnicity, underlying rheumatological conditions; vulnerability, vaccination status, and HRQOL scores. Patients were asked to rate the impact of the video: more likely to be vaccinated; less likely; no impact. Responses were collected 7-days following distribution.ResultsSurveys were sent 9.06.21 to 1636 patients; there were 628/1636 (38.3%) complete responses. Responders were mostly female (69%), Caucasian (96%), mean age 63years, most had an autoimmune rheumatic disease (75%) and half were clinically extremely vulnerable (47%); 623/628 (99%) were vaccinated and 45/628 (7%) had contracted COVID since the beginning of the pandemic. In total 424/628 (68%) reported watching the educational video; 422/468 (99%) reported receiving the vaccination. Of these 138/424 (32%) reported they were more likely to get the vaccine as a result, 285/424 (67%) reported it made no difference, and one patient (1%) reported that the video made them less likely to have the vaccine. Of the 5/628 (1%) non-vaccinated patients, reasons for not having the vaccine were concerns over vaccine side effects (2/5), and personal reasons including awaiting further vaccine data and awaiting home visit (3/5); 2/5 had watched the video, both reported the video made no difference to their decision and none had contracted COVID.ConclusionIn a research cohort of patients with rheumatic disease, following a targeted COVID-19 vaccine education video 32% were more likely to get the COVID vaccine, and the vast majority went on to be vaccinated. Within the limitations of a research study, these data contribute to evidence supporting the use of SMS technology to communicate key healthcare messages and targeted educational materials. Further research exploring the use of targeted educational materials and communications via SMS-text messaging could support in tackling vaccine hesitancy in this population.Disclosure H. Khatri: None. N. Cox: None. L. Rajagopala: None. J. Bateman: None.

A Web-Based Well-being Program for Health Care Workers (Thrive): Protocol for a Randomized Controlled Trial.

BackgroundMental health has come to be understood as not merely the absence of mental illness but also the presence of mental well-being, and recent interventions have sought to increase well-being in various populations. A population that deserves particular attention is that of health care workers, whose occupations entail high levels of stress, especially given the ongoing COVID-19 pandemic. A neuroscience-based web-based well-being program for health care workers—the Thrive program—has been newly developed to promote habits and activities that contribute to brain health and overall mental well-being.ObjectiveThis paper describes the protocol for a randomized controlled trial whose objective is to evaluate the Thrive program in comparison with an active control condition to measure whether the program is effective at increasing well-being and decreasing symptoms of psychological distress in health care workers at a designated Australian hospital.MethodsThe trial will comprise two groups (intervention vs active control) and 4 measurement occasions over a 12-week period. A survey will be administered in each of weeks 0, 4, 8, and 12, and the well-being program will be delivered in weeks 1-7 (via web-based video presentations or digital pamphlets). Each of the 4 surveys will comprise a range of questionnaires to measure well-being, psychological distress, and other key variables. The planned analyses will estimate group-by-time interaction effects to test the hypothesis that mental health will increase over time in the intervention condition relative to the active control condition.ResultsThe Thrive program was delivered to a small number of wards at the hospital between February 2021 and July 2021, and it will be delivered to the remaining wards from October 2021 to December 2021. A power calculation has recommended a sample size of at least 200 participants in total. A linear mixed model will be used to estimate the interaction effects.ConclusionsThis trial seeks to evaluate a new web-based well-being program for health care workers at a major public hospital. It will contribute to the growing body of research on mental well-being and ways to promote it.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12621000027819; https://tinyurl.com/58wwjut9International Registered Report Identifier (IRRID)DERR1-10.2196/34005

A Tailored Web-Based Video Intervention (ParentCoach) to Support Parents With Children With Sleeping Problems: User-Centered Design Approach.

BackgroundMany parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool ParentCoach was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems.ObjectiveThe aim of this paper is to illustrate the user-centered development of ParentCoach.MethodsWe conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration.ResultsIterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program.ConclusionsThis paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach.

Are clinical trials randomising households to lifestyle interventions to delay cognitive decline feasible? A pilot study to determine the beliefs, preferences, and deterrents for households impacted by dementia based on semi-structured interviews

IntroductionWhile lifestyle risk factors are implicated in the development and progression of cognitive impairment, interventional trials of individual participants have yielded unconvincing evidence. We sought to explore the development of lifestyle interventions targeting the household-unit.MethodsSemi-structured interviews were carried out among eight households affected by cognitive impairment (i.e. member of the household had cognitive impairment). Interviews took place online using a secure, web-based video platform recommended for patient clinician interaction. Interview content was analysed, and important themes identified.ResultsEighteen participants were interviewed within households, of which eight (one per household) had cognitive impairment and others were spouses or first-degree relatives living in the same home. Several themes emerged; 1) household members without cognitive impairment were more likely to report poor sleep habits, and sleep was perceived to be the hardest behaviour to change; 2) diet generated most interest as a potential lifestyle intervention target as most participants believed there is a strong link with nutrition and cognition; 3) physical activity is challenging to adapt due to lack of motivation and focus when individuals are cognitively impaired. Barriers to study participation, including risk of harm, complexity of intervention and deviation from routine emerged during discussions.ConclusionsThis study identified beliefs and preferences of households towards lifestyle intervention trials. Findings from this study may be used to inform future clinical trial protocols and future qualitative studies should explore acceptability and feasibility of digital intervention applications.

Content Quality of YouTube Videos About Gestational Diabetes: Systematic Evaluation.

BackgroundPeople with gestational diabetes have enhanced learning requirements during pregnancy, and management of their disease often requires the translation of health information into new health behavior changes. Seeking information from the internet to augment learning from health professionals is becoming more common during pregnancy. YouTube is a popular free and accessible web-based resource, which may be particularly useful for individuals with low health literacy or other barriers to receiving high-quality health care; however, the quality and content of YouTube videos varies, and little is known about those covering gestational diabetes.ObjectiveWe aimed to systematically evaluate the quality, content, and reliability of YouTube videos about gestational diabetes.MethodsA systematic search of YouTube videos was conducted over the course of 1 week in April 2020 using the following keywords: “gestational diabetes,” “gestational diabetes management,” “gestational diabetes treatment,” and “pregnancy and diabetes.” The search results were displayed by relevance, replicating a default YouTube search attempt. The first 60 results from each keyword were reviewed (n=240). Exclusion criteria were videos unrelated to gestational diabetes, videos not in English, and those for which the full video was not available at the time of review. For each unique video, a gestational diabetes content score was used to rate video comprehensiveness and accuracy, and the DISCERN instrument, a validated metric to assess consumer health information, was used to evaluate the reliability of information presented. Videos were further categorized by quality: videos with DISCERN scores lower than 3 (out of 5) or a content score less than 4 (out of 7) were categorized as low quality, and all others were designated high quality. We performed descriptive analysis and compared video characteristics by source and quality rating.ResultsFor 115 unique videos, the mean content score (out of 7) was 3.5 (SD 2.0) , and the mean DISCERN score (out of 5) was 2.7 (SD 0.7), representing low to moderate information comprehensiveness and reliability respectively. Video sources were categorized as personal vlog (12/115, 10.4%), web-based education (37/115, 32.2%), medical (52/115, 45.2%), business or company (13/115, 11.3%), and media clip (1/115, 0.9%). DISCERN and content scores trended higher among medical and web-based education videos. The majority of videos (n=88) were categorized as low quality, while 27 videos were categorized as high quality. Video duration was longer for high-quality videos (P<.001); high- and low-quality videos otherwise had similar views and viewer interaction numbers.ConclusionsAlthough high-quality videos about gestational diabetes exist, reliability, accuracy, and comprehensiveness were low overall, and higher quality was not associated with increased viewer interaction. It is important to acknowledge the limitations of this platform and to assist patients in accessing high quality content and differentiating the quality of information sources.

Engagement With Web-Based Fitness Videos on YouTube and Instagram During the COVID-19 Pandemic: Longitudinal Study.

BackgroundThe COVID-19 pandemic has drastically changed the physical activity (PA) landscape through the closures of gymnasiums, schools, and many outdoor spaces. Physical distancing guidelines have also reduced opportunity for PA. The popularity of free web-based home fitness videos on video hosting platforms (eg, YouTube and Instagram) has spiked during the pandemic. Many web-based fitness videos offer a convenient, accessible, and cost-effective means of engaging in PA through regularly posted videos or discrete programs. Notably, traditional PA programs often suffer from poor adherence and high dropout rates, despite many advantages over web-based workout programs (eg, equipment, feedback, and in-person engagement). Thus, notwithstanding clear advantages of these web-based fitness videos, their ability to maintain long-term engagement and adherence is unknown.ObjectiveWe explored patterns of engagement (ie, views, likes, and comments) for channels posting daily or program-based web-based fitness videos since the declaration of COVID-19 as a pandemic, over 4 months. Our secondary objective was to examine potential moderators of engagement metrics.MethodsAn environmental scan was used to identify eligible channels. Eligible channels were (1) freely available on YouTube or Instagram and (2) posted daily or weekday series workouts or offered quarantine-specific workout programs. Searches for eligible channels were conducted on June 1 and 4, 2020. Engagement metrics of views, likes, and comments were then collected from channels’ videos posted between March 11 and June 26 or 30, 2020, inclusive, on June 26 or July 8, 2020. A series of multilevel modeling analyses were conducted to examine longitudinal changes in each of the 3 outcome variables.ResultsTen channels were deemed eligible and included in analyses; 6 posted regularly, while the other 4 posted discrete workout programs. Multilevel models revealed that both views and likes significantly decreased across days. Visually, channels display the sharpest drop in engagement within the first week. Linear change estimate indicates that the number of views initially declined by 24,700 per day (95% CI –44,400 to –11,300, P=.01) on average across all the channels. Channels with more subscribers declined in their views, likes, and comments at a significantly higher rate than those with fewer subscribers (P≤.04). The day of the week a video is posted, “virality,” and content of a video appear to influence engagement. Integrating behavior change techniques and posting new and varied videos often may help garner further engagement with these videos. Future research should examine common elements of videos, which drive engagement.ConclusionsDespite raw engagement metrics, each channel demonstrated peak engagement with the initial video followed by decreased engagement with subsequent videos. As many countries maintain restrictions on traditional PA facilities owing to the COVID-19 pandemic, determining methods to improve engagement and adherence with web-based fitness videos becomes increasingly important.

SMART-ly Managing Type 1 Diabetes - Modifying Glucose Metabolism With an Online Mind-Body Intervention: A Feasibility and Pilot Study.

Managing type 1 diabetes is stressful. Stress physiology influences glucose metabolism. Continuous glucose monitors allow us to track glucose variability in the real-world environment. Managing stress and cultivating resiliency should improve diabetes management and reduce glucose variability. The study was designed as a randomized prospective cohort pre-post study with wait time control. Participants were adult type 1 diabetes patients who used a continuous glucose monitor and recruited from an academic endocrinology practice. The intervention was the Stress Management and Resiliency Training (SMART) program conducted over 8 sessions over web-based video conference software. The main outcome measures were Glucose variability, the Diabetes Self-Management questionnaire (DSMQ),Short-Form Six-Dimension (SF-6D), and the Connor-Davidson Resiliency (CD-RSIC) instrument. There was statistically significant improvement in participants DSMQ and CD RISC scores though the SF-6D did not change. Participants under age 50 years-old showed a statistically significant reduction in average glucose (p = .03) and Glucose Management Index (GMI) (p = .02). Participants also had reduced percentage of time high and increased time in range though this did not reach statistical significance. The participants found doing the intervention online acceptable if not always ideal. An 8-session stress management and resiliency training program reduced diabetes related stress and improved resiliency and reduced average blood glucose and GMI in those under 50 years-old. ClinicalTrials.gov, identifier NCT04944264.

Preferences for Technology-Mediated Behavioral Lifestyle Interventions With Different Levels of Coach and Peer Support Among Latino Men: Comparative Study Within One Arm of a Randomized Controlled Trial.

BackgroundAlthough Latino men have the highest prevalence (45%) of obesity among all men in the United States, traditional weight loss interventions have not effectively engaged this hard-to-reach and diverse group. Offering choices among technology-mediated weight loss interventions may offer advantages.ObjectiveThe aim of this study is to examine Latino men’s preferences among 3 weight loss intervention options. We also examined whether attendance in group sessions (videoconference and in person) and weight loss differed according to intervention choice.MethodsLatino men (n=200; mean age 47.3, SD 11.8 years) participated in a comparative effectiveness trial based on primary care and were randomized to receive the 1-year HOMBRE (Hombres con Opciones para Mejorar su Bienestar para Reducir Enfermedades Crónicas; English translation: Men With Options to Improve Their Well-being and Reduce Chronic Disease) intervention. HOMBRE is a weight loss intervention that offers 3 delivery options. During an orientation session, a trained bilingual coach helped men select 1 of the 3 intervention options that differed in coach, peer support, and available language. We used canonical discriminant analysis to assess multivariate associations of demographic, clinical, employment, cultural, and technology use and access factors with men’s intervention choices. We used generalized linear models to estimate weight loss at 6, 12, and 18 months for men in each intervention option.ResultsAmong Latino men, 28% (56/200) chose videoconference groups, 31% (62/200) chose web-based videos, and 41% (82/200) chose in-person groups. The canonical discriminant analysis identified 1 orthogonal dimension that distinguished between men who chose an in-person group and men who chose web-based videos. Men who were older, spoke Spanish, and did not use a computer frequently had a higher probability of choosing in-person groups versus web-based videos. For men who selected a group delivery option, 86.9% (107/123) attended ≥25% of the sessions, 83.7% (103/123) attended ≥50% of the sessions, and 73.2% (90/123) attended ≥75% of the sessions, with no differences by type of group (videoconference or in person). Men who chose videoconference and in-person group sessions lost significantly more weight at 6 months (both P<.001) and 18 months (P=.02 and P=.04, respectively) than those who chose web-based videos. Men who chose in-person group sessions also lost significantly more weight at 12 months (P=.008) than those who chose web-based videos.ConclusionsThere were significant differences according to demographic, employment, cultural, and technology use factors between men who chose 1 of the 3 intervention options. Men who chose one of the group-based options (videoconference or in person) lost significantly more weight than those who chose web-based videos. Providing options that accommodate the diversity of Latino men’s preferences is important for increasing engagement in behavioral interventions.Trial RegistrationClinicalTrials.gov NCT03092960; https://clinicaltrials.gov/ct2/show/NCT03092960