Quantifying Public Interest in Police Reforms by Mining Internet Search Data Following George Floyd's Death.

BACKGROUND: The death of George Floyd while in police custody has resurfaced serious questions about police conduct that result in the deaths of unarmed persons. OBJECTIVE: Data-driven strategies that identify and prioritize the public's needs may engender a public health response to improve policing. We assessed how internet searches indicative of interest in police reform changed after Mr Floyd's death. METHODS: We monitored daily Google searches (per 10 million total searches) that included the terms "police" and "reform(s)" (eg, "reform the police," "best police reforms," etc) originating from the United States between January 1, 2010, through July 5, 2020. We also monitored searches containing the term "police" with "training," "union(s)," "militarization," or "immunity" as markers of interest in the corresponding reform topics. RESULTS: The 41 days following Mr Floyd's death corresponded with the greatest number of police "reform(s)" searches ever recorded, with 1,350,000 total searches nationally. Searches increased significantly in all 50 states and Washington DC. By reform topic, nationally there were 1,220,000 total searches for "police" and "union(s)"; 820,000 for "training"; 360,000 for "immunity"; and 72,000 for "militarization." In terms of searches for all policy topics by state, 33 states searched the most for "training," 16 for "union(s)," and 2 for "immunity." States typically in the southeast had fewer queries related to any police reform topic than other states. States that had a greater percentage of votes for President Donald Trump during the 2016 election searched more often for police "union(s)" while states favoring Secretary Hillary Clinton searched more for police "training." CONCLUSIONS: The United States is at a historical juncture, with record interest in topics related to police reform with variability in search terms across states. Policy makers can respond to searches by considering the policies their constituencies are searching for online, notably police training and unions. Public health leaders can respond by engaging in the subject of policing and advocating for evidence-based policy reforms.

Characteristics of X (Formerly Twitter) Community Notes Addressing COVID-19 Vaccine Misinformation.

This study evaluated the topics, accuracy, and credibility of X (formerly Twitter) Community Notes addressing COVID-19 vaccination.

Can a selfie promote public engagement with skin cancer?

Social media may provide new opportunities to promote skin cancer prevention, but research to understand this potential is needed. In April of 2015, Kentucky native Tawny Willoughby (TW) shared a graphic skin cancer selfie on Facebook that subsequently went viral. We examined the volume of comments and shares of her original Facebook post; news volume of skin cancer from Google News; and search volume for skin cancer Google queries. We compared these latter metrics after TWs announcement against expected volumes based on forecasts of historical trends. TWs skin cancer story was picked up by the media on May 11, 2015 after the social media post had been shared approximately 50,000 times. All search queries for skin cancer increased 162% (95% CI 102 to 320) and 155% (95% CI 107 to 353) on May 13th and 14th, when news about TW's skin cancer selfie was at its peak, and remained higher through May 17th. Google searches about skin cancer prevention and tanning were also significantly higher than expected volumes. In practical terms, searches reached near-record levels - i.e., May 13th, 14th and 15th were respectively the 6th, 8th, and 40th most searched days for skin cancer since January 1, 2004 when Google began tracking searches. We conclude that an ordinary person's social media post caught the public's imagination and led to significant increases in public engagement with skin cancer prevention. Digital surveillance methods can rapidly detect these events in near real time, allowing public health practitioners to engage and potentially elevate positive effects.

Recall of anti-tobacco advertisements and effects on quitting behavior: results from the California smokers cohort.

OBJECTIVES: We assessed whether an anti-tobacco television advertisement called "Stages," which depicted a woman giving a brief emotional narrative of her experiences with tobacco use, would be recalled more often and have a greater effect on smoking cessation than 3 other advertisements with different intended themes. METHODS: Our data were derived from a sample of 2596 California adult smokers. We used multivariable log-binomial and modified Poisson regression models to calculate respondents' probability of quitting as a result of advertisement recall. RESULTS: More respondents recalled the "Stages" ad (58.5%) than the 3 other ads (23.1%, 23.4%, and 25.6%; P<.001). Respondents who recalled "Stages" at baseline had a higher probability than those who did not recall the ad of making a quit attempt between baseline and follow-up (adjusted risk ratio [RR]=1.18; 95% confidence interval [CI]=1.03, 1.34) and a higher probability of being in a period of smoking abstinence for at least a month at follow-up (adjusted RR=1.55; 95% CI=1.02, 2.37). CONCLUSIONS: Anti-tobacco television advertisements that depict visceral and personal messages may be recalled by a larger percentage of smokers and may have a greater impact on smoking cessation than other types of advertisements.

Availability and Promotion of Cannabidiol (CBD) Products in Online Vape Shops.

Vaping products containing cannabidiol (CBD), a cannabis-derived compound used in wellness products and available in all 50 US states, were recently implicated in outbreaks of poisonings. Little is known about the commercial availability of CBD products in vape shops (i.e., stores that sell e-cigarettes). To document the availability and marketing of CBD products in online vape shops, in June 2020, we used the Google Chrome browser without cached data to collect the first two pages of search results generated by five Google queries (n = 100 search results) indicative of shopping for vaping products (e.g., "order vapes"). We then determined whether and what type of CBD products could be mail-ordered from the returned websites, and whether any explicit health claims were made about CBD. Over a third of the search results (n = 37; 37.0%) directed to vape shops that allowed visitors to also mail-order CBD. These shops sold 12 distinct categories of CBD products-some with direct analogs of tobacco or cannabis products including CBD cigarettes, edibles, flowers, pre-rolled joints, and vapes. Two vape shops made explicit health claims of the therapeutic benefits of CBD use, including in the treatment of anxiety, inflammation, pain, and stress. The abundance and placement of CBD in online vape shops suggests a growing demand and appeal for CBD products among e-cigarette users. Additional surveillance on the epidemiology of CBD use and its co-use with tobacco is warranted.

Effect size reporting among prominent health journals: a case study of odds ratios.

BACKGROUND: The accuracy of statistical reporting that informs medical and public health practice has generated extensive debate, but no studies have evaluated the frequency or accuracy of effect size (the magnitude of change in outcome as a function of change in predictor) reporting in prominent health journals. OBJECTIVE: To evaluate effect size reporting practices in prominent health journals using the case study of ORs. DESIGN: Articles published in the American Journal of Public Health (AJPH), Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM) and PLOS One from 1 January 2010 through 31 December 2019 mentioning the term 'odds ratio' in all searchable fields were obtained using PubMed. One hundred randomly selected articles that reported original research using ORs were sampled per journal for in-depth analysis. MAIN OUTCOMES AND MEASURES: We report prevalence of articles using ORs, reporting effect sizes from ORs (reporting the magnitude of change in outcome as a function of change in predictor) and reporting correct effect sizes. RESULTS: The proportion of articles using ORs in the past decade declined in JAMA and AJPH, remained similar in NEJM and increased in PLOS One, with 6124 articles in total. Twenty-four per cent (95% CI 20% to 28%) of articles reported the at least one effect size arising from an OR. Among articles reporting any effect size, 57% (95% CI 47% to 67%) did so incorrectly. Taken together, 10% (95% CI 7% to 13%) of articles included a correct effect size interpretation of an OR. Articles that used ORs in AJPH more frequently reported the effect size (36%, 95% CI 27% to 45%), when compared with NEJM (26%, 95% CI 17.5% to 34.7%), PLOS One (22%, 95% CI 13.9% to 30.2%) and JAMA (10%, 95% CI 3.9% to 16.0%), but the probability of a correct interpretation did not statistically differ between the four journals (χ2=0.56, p=0.90). CONCLUSIONS: Articles that used ORs in prominent journals frequently omitted presenting the effect size of their predictor variables. When reported, the presented effect size was usually incorrect. When used, ORs should be paired with accurate effect size interpretations. New editorial and research reporting standards to improve effect size reporting and its accuracy should be considered.

Real-world exposure to graphic warning labels on cigarette packages in US smokers: The CASA randomized trial protocol.

BACKGROUND: The US lags behind >120 countries in implementing graphic warning labels (GWLs) on cigarette packs. US courts prevented implementation of FDA's 2012 rule requiring GWLs citing the need for more evidence on effectiveness. After more research, in 2020, the FDA proposed a revised rule mandating GWLs. This trial will test how the introduction of GWLs influence cognitions and behavior in US smokers. METHOD: To investigate the "real-world" impact of GWLs in US smokers, we are conducting a randomized trial involving a 3-month intervention and 8-month follow-up. The study recruited California smokers between September 2016 through December 2019 and randomly assigned them into 3 groups (1) Blank Pack devoid of any cigarette branding; (2) GWL Pack featuring 1 of 3 rotating images added to blank pack; or (3) their usual Standard US Pack. Throughout the 3-month intervention, participants purchased study-packaged cigarettes and reported daily cognitions and behavior through ecological momentary assessments. We will validate self-reported tobacco use with saliva cotinine concentrations following the 3-month intervention and 8-month follow-up. RESULTS: The trial enrolled 359 participants (average age 39 years; average cigarette consumption half a pack/day). The 3 study groups were balanced on age, gender, race-ethnicity, education and income (17% low income) as well as on smoking related variables. CONCLUSIONS: This 3-month real-world randomized trial will test the effect of repackaging cigarettes from standard US packs to GWL plain packs on smokers' perceptions of the risks of smoking, their perception of the appeal of their cigarettes, and on their smoking behavior.

Evaluating Artificial Intelligence Responses to Public Health Questions.

This cross-sectional study analyzes the quality of ChatGPT responses to public health questions.

Leveraging Big Data to Improve Health Awareness Campaigns: A Novel Evaluation of the Great American Smokeout.

BACKGROUND: Awareness campaigns are ubiquitous, but little is known about their potential effectiveness because traditional evaluations are often unfeasible. For 40 years, the "Great American Smokeout" (GASO) has encouraged media coverage and popular engagement with smoking cessation on the third Thursday of November as the nation's longest running awareness campaign. OBJECTIVE: We proposed a novel evaluation framework for assessing awareness campaigns using the GASO as a case study by observing cessation-related news reports and Twitter postings, and cessation-related help seeking via Google, Wikipedia, and government-sponsored quitlines. METHODS: Time trends (2009-2014) were analyzed using a quasi-experimental design to isolate spikes during the GASO by comparing observed outcomes on the GASO day with the simulated counterfactual had the GASO not occurred. RESULTS: Cessation-related news typically increased by 61% (95% CI 35-87) and tweets by 13% (95% CI -21 to 48) during the GASO compared with what was expected had the GASO not occurred. Cessation-related Google searches increased by 25% (95% CI 10-40), Wikipedia page visits by 22% (95% CI -26 to 67), and quitline calls by 42% (95% CI 19-64). Cessation-related news media positively coincided with cessation tweets, Internet searches, and Wikipedia visits; for example, a 50% increase in news for any year predicted a 28% (95% CI -2 to 59) increase in tweets for the same year. Increases on the day of the GASO rivaled about two-thirds of a typical New Year's Day-the day that is assumed to see the greatest increases in cessation-related activity. In practical terms, there were about 61,000 more instances of help seeking on Google, Wikipedia, or quitlines on GASO each year than would normally be expected. CONCLUSIONS: These findings provide actionable intelligence to improve the GASO and model how to rapidly, cost-effectively, and efficiently evaluate hundreds of awareness campaigns, nearly all for the first time.