Evaluation of treatment information quality on hypertension and diabetes on WeChat and TikTok: A cross-sectional content analysis.

Objective: This study aimed to assess the quality of the information in WeChat and TikTok videos related to hypertension and diabetes treatment. Methods: A sample of 120 Chinese videos was collected based on specific inclusion and exclusion criteria. The quality was evaluated using DISCERN, JAMA and the latest edition of Chinese guidelines for hypertension and diabetes prevention and treatment, and two observers independently scored each video using the three assessment tools. Results: Among all 120 videos, only 10 scored above 38 points in DISCERN, with 45 videos rated as "very poor". None of the video met all JAMA criteria simultaneously, and there were gaps in accuracy and completeness compared to the two guidelines. Furthermore, there was no significant correlation between information quality and the number of likes and comments. Conclusion: The current quality of information on the treatment of hypertension and diabetes on WeChat and TikTok was unsatisfactory. Consequently, the government should strengthen oversight of information quality, and social media platforms should actively review health-related content to prevent inaccurate information dissemination. Individuals should enhance their digital and health literacy.

Using Civic Service Design Methods to Redevelop a Data Communication Website With a Health Literacy Lens.

CONTEXT: Public health agencies routinely publish data in hopes that data influence public health policy and practice. However, data websites can often be difficult to use, posing barriers to people trying to access, understand, and use data. Working to make data websites easier to use can add value to public health data communication work. PROGRAM: The New York City Department of Health and Mental Hygiene (DOHMH) redesigned its Environment and Health Data Portal, a website used to communicate environmental health data, with the goal of making data more accessible and understandable to a broader audience. The DOHMH used Civic Service Design methods to establish priorities and strategies for the redesign work, to build a data communication website that emphasizes a high level of usability, and content that explains data. IMPLEMENTATION: By following a Civic Service Design process, the DOHMH synthesized findings from health communications, data visualization and communication, and web usability to create an easy-to-use website with explanations of data and findings alongside datasets. On the new site, automated dataset visualizations are supplemented with narrative content, explanatory content, and custom interactive applications designed to explain data and findings. EVALUATION: Web analytics showed that, in its first year of operation, the site's web traffic grew substantially, with the last 12 weeks recording weekly page views 150% higher than the first 12 weeks of operation (7185 average weekly page views compared with 2866 average weekly page views). Two-thirds (66.3%) of page views include recorded user engagement. Additional evaluations to measure specific aspects of usability compared with the previous version of the site are planned. DISCUSSION: By following a Civic Service Design process, the DOHMH redesigned a vital data communication platform to increase its usability and saw significant increase in engagement in its first year of operations. By designing data material with usability in mind, public health departments have the potential to improve public health data communication work.

Evidence of validity of the Risk Self-Medication Questionnaire focused on Health Literacy.

OBJECTIVES: to analyze the validity evidence of the internal structure of the Risk Self-Medication Questionnaire Focused on Health Literacy. METHODS: a psychometric study with 499 adults. The internal structure was assessed with exploratory and confirmatory factor analysis to prove the adjustment. Internal consistency was measured by composite reliability and McDonald's omega coefficient (ω). RESULTS: the parameters revealed a model of 35 items distributed across four factors, explaining 56% of the total variance, with factor loadings ranging from 0.31 to 0.85 and adequate communalities. Accuracy (0.79

Association of Obesity With Health Literacy and Weight Perception Among Women Merchants in Abidjan, Côte d'Ivoire: A Cross-Sectional Study.

BACKGROUND: In Abidjan, Côte d'Ivoire's largest city, obesity rates among women are increasing, posing a major health challenge, especially for the working generation. Merchants represent 64.3% of working women and are a typical occupation for women with low- and middle-income. Health literacy is used to prevent and overcome chronic diseases and can be used as anti-obesity measures. OBJECTIVE: The aim of this study was to examine the relationship between obesity, health literacy, and weight perception among women merchants in Abidjan. METHODS: In this cross-sectional study, we conducted a complete enumeration survey among women merchants in a market in Abidjan from December 2020 to December 2021. In addition to anthropometric measurements, structured face-to-face interviews were conducted. The participants were asked about their weight perception, weight management behaviors, and sociodemographic attributes. They also responded to the Health Literacy Questionnaire (HLQ). Data were tabulated using descriptive statistics, and multiple logistic regression analysis was performed to examine obesity's association with HLQ scales, weight perception, and weight management behaviors. KEY RESULTS: Of the 873 participants, 259 (29.7%) were obese; 82% of them underestimated their weight. Obesity was associated with a higher rate of HLQ1 (Feeling understood and supported by health care providers) (odds ratio [OR] = 2.926, confidence interval [CI]:1.450-5.901, p = .03), a lower score of HLQ3 (Actively managing my health) (OR = 0.343, CI:0.165-0.716, p = 0.004), a lower rate of accurate weight perception (OR = 0.145, CI: 0.093-0.224, p < .001), and a lower rate of eating at least three meals per day (OR = 0.401, CI:0.260-0.617, p < .001). CONCLUSIONS: Findings from this study of Abidjan women merchants include obese participants' lack of a proactive attitude toward personal health management, and the association of factors such as inaccurate weight perception and eating fewer than three meals per day with obesity. These finding have important implications for future anti-obesity measures. [HLRP: Health Literacy Research and Practice. 2024;8(2):e102-e112.].

PLAIN LANGUAGE SUMMARY: We found the relationship between obesity and health literacy among women merchants, Abidjan in Côte d'Ivoire. The results showed that participants with obesity lacked proactive attitude toward personal health management among health literacy skills. Anti-obesity measures in Abidjan need to incorporate this aspect of the health literacy skills.

Evaluating the Readability, Quality, and Reliability of Online Patient Education Materials on Spinal Cord Stimulation.

AIM: To obtain health-related information internet usage is rapidly increasing. However, there are concerns about the comprehensibility and reliability of internet-accessed health-related information. The aim of this research was to investigate the reliability, quality, and readability of patient education materials (PEMs) about spinal cord stimulation (SCS) on the internet. MATERIAL AND METHODS: A total of 114 websites suitable for the study were identified after a search on Google for the term "spinal cord stimulation." Gunning Fog (GFOG), Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), and Simple Measure of Gobbledygook (SMOG) were used to determine the readability of sites. The credibility of the websites was assessed using the Journal of the American Medical Association (JAMA) score. Quality was assessed using the global quality score (GQS), the DISCERN score, and the Health on the Net Foundation code of conduct (HONcode). RESULTS: Evaluating the text sections, the mean SMOG and FKGL were 10.92 ± 1.61 and 11.62 ± 2.11 years, respectively, and the mean FRES and GFOG were 45.32 ± 10.71 and 14.62 ± 2.24 (both very difficult), respectively. Of all the websites, 10.5% were found to be of high quality, 13.2% were found to be of high reliability, and only 6.1% had a HONcode. A significant difference was found between the typologies of the websites and the reliability and quality scores (p < 0.05). CONCLUSION: The internet-based PEMs about SCS were found to have a readability level that exceeded the Grade 6 level recommended by the National Health Institute. However, the materials demonstrated low reliability and poor quality. It is advisable that websites addressing Spinal Cord Stimulation (SCS), a specific neuromodulation technique among various interventional strategies for chronic pain management, maintain readability standards in line with established indexes and provide content that is reliable and tailored to the general public's educational level.

Efficacy of the Flo App in Improving Health Literacy, Menstrual and General Health, and Well-Being in Women: Pilot Randomized Controlled Trial.

BACKGROUND: Reproductive health literacy and menstrual health awareness play a crucial role in ensuring the health and well-being of women and people who menstruate. Further, awareness of one's own menstrual cycle patterns and associated symptoms can help individuals identify and manage conditions of the menstrual cycle such as premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Digital health products, and specifically menstrual health apps, have the potential to effect positive change due to their scalability and ease of access. OBJECTIVE: The primary aim of this study was to measure the efficacy of a menstrual and reproductive health app, Flo, in improving health literacy and health and well-being outcomes in menstruating individuals with and without PMS and PMDD. Further, we explored the possibility that the use of the Flo app could positively influence feelings around reproductive health management and communication about health, menstrual cycle stigma, unplanned pregnancies, quality of life, work productivity, absenteeism, and body image. METHODS: We conducted 2 pilot, 3-month, unblinded, 2-armed, remote randomized controlled trials on the effects of using the Flo app in a sample of US-based (1) individuals who track their cycles (n=321) or (2) individuals who track their cycles and are affected by PMS or PMDD (n=117). RESULTS: The findings revealed significant improvements at the end of the study period compared to baseline for our primary outcomes of health literacy (cycle tracking: D̄=1.11; t311=5.73, P<.001; PMS or PMDD: D̄=1.20; t115=3.76, P<.001) and menstrual health awareness (D̄=3.97; t311=7.71, P<.001), health and well-being (D̄=3.44; t311=5.94, P<.001), and PMS or PMDD symptoms burden (D̄=-7.08; t115=-5.44, P<.001). Improvements were also observed for our secondary outcomes of feelings of control and management over health (D̄=1.01; t311=5.08, P<.001), communication about health (D̄=0.93; t311=2.41, P=.002), menstrual cycle stigma (D̄=-0.61; t311=-2.73, P=.007), and fear of unplanned pregnancies (D̄=-0.22; t311=-2.11, P=.04) for those who track their cycles, as well as absenteeism from work and education due to PMS or PMDD (D̄=-1.67; t144=-2.49, P=.01). CONCLUSIONS: These pilot randomized controlled trials demonstrate that the use of the Flo app improves menstrual health literacy and awareness, general health and well-being, and PMS or PMDD symptom burden. Considering the widespread use and affordability of the Flo app, these findings show promise for filling important gaps in current health care provisioning such as improving menstrual knowledge and health. TRIAL REGISTRATION: OSF Registries osf.io/pcgw7; https://osf.io/pcgw7 ; OSF Registries osf.io/ry8vq; https://osf.io/ry8vq.

Enhancing Readability of Online Patient-Facing Content: The Role of AI Chatbots in Improving Cancer Information Accessibility.

BACKGROUND: Internet-based health education is increasingly vital in patient care. However, the readability of online information often exceeds the average reading level of the US population, limiting accessibility and comprehension. This study investigates the use of chatbot artificial intelligence to improve the readability of cancer-related patient-facing content. METHODS: We used ChatGPT 4.0 to rewrite content about breast, colon, lung, prostate, and pancreas cancer across 34 websites associated with NCCN Member Institutions. Readability was analyzed using Fry Readability Score, Flesch-Kincaid Grade Level, Gunning Fog Index, and Simple Measure of Gobbledygook. The primary outcome was the mean readability score for the original and artificial intelligence (AI)-generated content. As secondary outcomes, we assessed the accuracy, similarity, and quality using F1 scores, cosine similarity scores, and section 2 of the DISCERN instrument, respectively. RESULTS: The mean readability level across the 34 websites was equivalent to a university freshman level (grade 13±1.5). However, after ChatGPT's intervention, the AI-generated outputs had a mean readability score equivalent to a high school freshman education level (grade 9±0.8). The overall F1 score for the rewritten content was 0.87, the precision score was 0.934, and the recall score was 0.814. Compared with their original counterparts, the AI-rewritten content had a cosine similarity score of 0.915 (95% CI, 0.908-0.922). The improved readability was attributed to simpler words and shorter sentences. The mean DISCERN score of the random sample of AI-generated content was equivalent to "good" (28.5±5), with no significant differences compared with their original counterparts. CONCLUSIONS: Our study demonstrates the potential of AI chatbots to improve the readability of patient-facing content while maintaining content quality. The decrease in requisite literacy after AI revision emphasizes the potential of this technology to reduce health care disparities caused by a mismatch between educational resources available to a patient and their health literacy.

Evaluating Quality, Credibility, and Readability of Online Over-the-Counter Hearing Aid Information.

OBJECTIVE: With over-the-counter hearing aids being recently approved by the United States Food and Drug Administration, the accuracy and usefulness of online information has not yet been examined. This study evaluates the quality, credibility, readability, and accessibility of online over-the-counter hearing aids education materials. METHODS: Google was queried using the search term "over-the-counter hearing aids". The top 50 results were categorized into healthcare versus non-healthcare authored resources. The Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) tests were utilized to assess readability, whereas the Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test and DISCERN instruments were used to assess quality and credibility. The number of clicks taken to access relevant information on each website was used to assess accessibility. RESULTS: There was no significant difference in FRES or FKGL readability scores between healthcare and non-healthcare authored websites (p = 0.5548, p = 0.5981, respectively), but both readability scores were higher than that of the recommended reading level for patient education materials. There was no significant difference in CRAAP and DISCERN scores between both groups (p = 0.5746, p = 0.1699, respectively). The number of clicks did not significantly differ between healthcare and non-healthcare authored resources (p = 0.4932). CONCLUSION: This study highlights poor readability and accessibility of virtual healthcare information regarding OTC hearing aids. Although credibility in articles authored by healthcare and non-healthcare professionals was adequate, readability was greatly compromised due to the written information exceeding the recommended United States reading level. Accessibility posed a similar issue, as many sites required multiple clicks to access product information. LEVEL OF EVIDENCE: NA Laryngoscope, 134:3302-3309, 2024.

Relationship between health literacy and COVID-19 knowledge: A cross-sectional study.

Background: Health literacy (HL) is a protective factor for some chronic diseases. However, its role in the Coronavirus Disease 2019 (COVID-19) pandemic has not been clarified. This study aims to explore the association between HL and COVID-19 knowledge among residents in Ningbo. Methods: A total of 6,336 residents aged 15-69 years in Ningbo were selected by multi-stage stratified random sampling method. The "Health Literacy Questionnaire of Chinese Citizens (2020)" was used to evaluate the relationship between COVID-19 knowledge and HL. Chi-square test, Mann-Whitney U test and logistic regression were used to analyze the data. Results: The HL and COVID-19 knowledge levels of Ningbo residents were 24.8% and 15.7%, respectively. After adjusting for confounding factors, people with adequate HL were the more likely to have adequate COVID-19 knowledge compared with those with limited HL (OR = 3.473, 95% CI = 2.974-4.057, P <0.001). Compared with the limited HL group, the adequate HL group had a higher rate of COVID-19 knowledge, a more positive attitude, and a more active behavior. Conclusion: COVID-19 knowledge is significantly associated with HL. Improving HL may influence people's knowledge about COVID-19, thereby changing people's behaviors, and finally combating the pandemic.

Linguistic analysis of plain language summaries and corresponding scientific summaries of Cochrane systematic reviews about oncology interventions.

BACKGROUND: Cochrane plain language summaries (PLSs) are an important format to present high-quality healthcare evidence to patients with cancer and their families. They should be written in a way everyone can understand, since they serve as a tool in decision-making and present a bridge to overcome the gap between the healthcare users and professionals. OBJECTIVE: The aim of the study was to assess the language characteristics of PLSs of Cochrane systematic reviews of oncology interventions in comparison with corresponding Cochrane scientific abstracts (SAs). METHODS: In this cross-sectional study, we included all Cochrane PLSs and SAs of systematic reviews of oncology interventions available in the Cochrane Database of Systematic Reviews. We assessed text readability, measured using the Simple Measure of Gobbledygook (SMOG) index, and the prevalence of words related to different language tones (clout, authenticity, emotions and analytical tones). Two independent assessors categorized the conclusiveness of the efficacy of interventions into nine categories. RESULTS: The overall median SMOG index for 275 PLSs was 13.0 (95% confidence interval [CI] 12.8-13.3). Readability scores did not differ across Cochrane Review Groups. SAs had a higher readability index than the corresponding PLSs (median = 16.6, 95% CI = 16.4-16.8). Regarding linguistic characteristics, PLSs were shorter than SAs, with less use of analytical tone, but more use of a positive emotional tone and authenticity. Overall, the 'Unclear' category of conclusiveness was the most common among all PLSs. Also, PLSs with 'No evidence' conclusions were the shortest and had the lowest SMOG index. CONCLUSION: PLSs of Cochrane systematic reviews of oncological interventions have low readability and most give unclear conclusions about the efficacy of interventions. PLSs should be simplified so that patients and their families can benefit from appropriate health information on evidence synthesis. Further research is needed into reasons for unclear language to describe evidence from oncology trials.

Interactive Voice Response Service to Improve High School Students Covid-19 Literacy in Burkina Faso: A Usability Study.

Mobile technology is widely used in healthcare. However, designers and developers in many cases have focused on developing solutions that are often tailored to highly literate people. While the advent of the pandemic has called for people to seek and use Covid-19 related information to adapt their behaviors, it is relatively difficult for low literate to get easily access to health information through digital technologies. In this study, we present a Mobile based Interactive Voice Response service designed particularly for low-literate people which provides validated Covid-19 related health information in local African languages. We conducted a field study, among high school students, through a usability study to assess users' perception. The service received an excellent numerical usability score of 78.75.

Development of a computerized intervention to improve health literacy in older Hispanics with type 2 diabetes using a pharmacist supervised comprehensive medication management.

OBJECTIVE: The primary objective was to develop a computerized culturally adapted health literacy intervention for older Hispanics with type 2 diabetes (T2D). Secondary objectives were to assess the usability and acceptability of the intervention by older Hispanics with T2D and clinical pharmacists providing comprehensive medication management (CMM). MATERIALS AND METHODS: The study occurred in three phases. During phase I, an integration approach (i.e., quantitative assessments, qualitative interviews) was used to develop the intervention and ensure cultural suitability. In phase II, the intervention was translated to Spanish and modified based on data obtained in phase I. During phase III, the intervention was tested for usability/acceptability. RESULTS: Thirty participants (25 older Hispanics with T2D, 5 clinical pharmacists) were included in the study. Five major themes emerged from qualitative interviews and were included in the intervention: 1) financial considerations, 2) polypharmacy, 3) social/family support, 4) access to medication/information, and 5) loneliness/sadness. Participants felt the computerized intervention developed was easy to use, culturally appropriate, and relevant to their needs. Pharmacists agreed the computerized intervention streamlined patient counseling, offered a tailored approach when conducting CMM, and could save them time. CONCLUSION: The ability to offer individualized patient counseling based on information gathered from the computerized intervention allows for precision counseling. Future studies are needed to determine the effectiveness of the developed computerized intervention on adherence and health outcomes.

Breast cancer screening literacy information on online platforms: A content analysis of YouTube videos.

BACKGROUND: The YouTube platform has great potential of serving as a healthcare resource due to its easy accessibility, navigability and wide audience reach. Breast cancer screening is an important preventative measure that can reduce breast cancer mortality by 40%. Therefore, platforms being used as a healthcare resources, such as YouTube, can and should be used to advocate for essential preventative measures such as breast cancer screening. METHODS: In this study, the usefulness of videos related to breast cancer and breast cancer screening were analyzed. Videos were first screened for inclusion and then were categorized into very useful, moderately useful, somewhat useful, and not useful categories according to a 10-point criteria scale developed by medical professionals based on existing breast cancer screening guidelines. Two reviewers independently assessed each video using the scale. RESULTS: 200 videos were identified in the preliminary analysis (100 for the search phrase 'breast cancer' and 100 for the search phrase 'breast cancer screening'). After exclusion of duplicates and non-relevant videos, 162 videos were included in the final analysis. We found the following distribution of videos: 4.3% very useful, 17.9% moderately useful, 39.5% somewhat useful, and 38.3% not useful videos. There was a significant association between each of the following and the video's level of usefulness: video length, the number of likes, and the uploading source. Longer videos were very useful, somewhat useful videos were the most liked, personally produced videos were the most not useful, and advertisements produced the highest ratio of very useful to not useful videos. CONCLUSION: It is necessary to create more reliable and useful healthcare resources for the general population as well as to monitor health information on easily accessible social platforms such as YouTube.

Assessing adolescents' critical health literacy: How is trust in government leadership associated with knowledge of COVID-19?

This study explored relations between COVID-19 news source, trust in COVID-19 information source, and COVID-19 health literacy in 194 STEM-oriented adolescents and young adults from the US and the UK. Analyses suggest that adolescents use both traditional news (e.g., TV or newspapers) and social media news to acquire information about COVID-19 and have average levels of COVID-19 health literacy. Hierarchical linear regression analyses suggest that the association between traditional news media and COVID-19 health literacy depends on participants' level of trust in their government leader. For youth in both the US and the UK who used traditional media for information about COVID-19 and who have higher trust in their respective government leader (i.e., former US President Donald Trump and UK Prime Minister Boris Johnson) had lower COVID-19 health literacy. Results highlight how youth are learning about the pandemic and the importance of not only considering their information source, but also their levels of trust in their government leaders.

Preferences for More or Less Health Care and Association With Health Literacy of Men Eligible for Prostate-Specific Antigen Screening in Australia.

Importance: Understanding personal factors that influence diverse responses to health care information, such as preferences for more or less health care, might be beneficial to more effective communication and better involvement in health care choices. Objective: To determine whether individuals' preferences for more or less health care are associated with informed choice and understanding of overdiagnosis in routine prostate cancer screening and to examine associations among preferences, educational status, and health literacy. Design, Setting, and Participants: This survey study included a community-based sample of men in Australia aged 45 to 60 years eligible for prostate-specific antigen (PSA) screening, recruited via an international social research company. Survey data were collected online from June 27 to July 26, 2018. Data were analyzed in April 2020. Exposures: Participants were randomized to 1 of 2 versions of an online decision aid (full-length or abbreviated) about PSA screening and completed an online survey that included a measure of preference for more or less health care, the Medical Maximizer-Minimizer Scale (MMS), in which higher score indicates preference for more health care. Main Outcomes and Measures: The primary outcome was informed choice; knowledge, attitudes, and intentions about screening for prostate cancer were also measured. Results: Of 3722 participants who began the survey, 2993 (80.4%) completed it (mean [SD] age, 52.15 [6.65] years). Stronger preferences for more heath care were observed in those without tertiary education (mean difference, 0.15; 95% CI, 0.09-0.22; P < .001) and with inadequate health literacy (mean difference, 0.16; 95% CI, 0.09-0.22; P < .001). After controlling for health and demographic variables, a 1-unit increase in MMS score was associated with reduced relative risk (RR) of making an informed choice (RR, 0.78; 95% CI, 0.74-0.82; P < .001) and of having adequate conceptual knowledge (RR, 0.87; 95% CI, 0.84-0.90; P < .001), correct numerical knowledge (RR, 0.93; 95% CI, 0.89-0.97; P = .001), and correct understanding of overdiagnosis (RR, 0.84; 95% CI, 0.79-0.90; P < .001). A 1-unit increase in MMS score was associated with a more positive attitude toward screening (RR, 1.18; 95% CI, 1.15-1.21; P < .001) and more positive intention to screen (RR, 1.20; 95% CI, 1.16-1.25; P < .001) after adjusting for control variables. Conclusions and Relevance: This survey study examined associations between preferences for more or less health care and knowledge about overdiagnosis and informed choice among men in Australia. These results may motivate clinicians to elicit individual patient preferences to facilitate tailored discussions with patients about low-value care, such as prostate cancer screening, for which benefit is uncertain.