The effectiveness of visual-based interventions on health literacy in health care: a systematic review and meta-analysis.

BACKGROUND: Limited Health Literacy (HL) is an obstacle to accessing and receiving optimal health care and negatively impacts patients' quality of life, thus making it an urgent issue in the health care system. Visual-based interventions are a promising strategy to improve HL through the use of visual aids and pictorial materials to explain health-related concepts. However, a comprehensive summary of the literature on the topic is still scarce. METHODS: To fill this gap, we carried out a systematic review and meta-analysis with the aim to determine the effectiveness of visual-based interventions in improving comprehension of health related material in the clinical population. Independent studies evaluating the effectiveness of visual-based interventions on adults (> 18 years) and whose primary outcome was either health literacy (HL) or comprehension were eligible for the review. After a systematic literature search was carried out in five databases, 28 studies met the inclusion criteria and thus were included. Most of the studies were randomized controlled trials and they focused on HL and health knowledge as outcomes. RESULTS: The review and meta-analysis showed that visual-based interventions were most effective in enhancing the comprehension of health-related material compared to traditional methods. According to meta-analytic results, videos are more effective than traditional methods (Z = 5.45, 95% CI [0.35, 0.75], p < 0.00001) and than the employment of written material (Z = 7.59, 95% CI [0.48, 0.82], p < 0.00001). Despite this, no significant difference was found between video and oral discussion (Z = 1.70, 95% CI [-0.46, 0.53], p = 0.09). CONCLUSIONS: We conclude that visual-based interventions, particularly the ones using videos, are effective for improving HL and the comprehension of health-related material.

Physician Perspectives on Internet-Informed Patients: Systematic Review.

BACKGROUND: The internet has become a prevalent source of health information for patients. However, its accuracy and relevance are often questionable. While patients seek physicians' expertise in interpreting internet health information, physicians' perspectives on patients' information-seeking behavior are less explored. OBJECTIVE: This review aims to understand physicians' perceptions of patients' internet health information-seeking behavior as well as their communication strategies and the challenges and needs they face with internet-informed patients. METHODS: An initial search in PubMed, Scopus, CINAHL, Communication and Mass Media Complete, and PsycINFO was conducted to collect studies published from January 1990 to August 1, 2022. A subsequent search on December 24, 2023, targeted recent studies published after the initial search cutoff date. Two reviewers independently performed title, abstract, and full-text screening, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Thematic analysis was then used to identify key themes and systematically categorize evidence from both qualitative and quantitative studies under these themes. RESULTS: A total of 22 qualifying articles were identified after the search and screening process. Physicians were found to hold diverse views on patients' internet searches, which can be viewed as a continuous spectrum of opinions ranging from positive to negative. While some physicians leaned distinctly toward either positive or negative perspectives, a significant number expressed more balanced views. These physicians recognized both the benefits, such as increased patient health knowledge and informed decision-making, and the potential harms, including misinformation and the triggering of negative emotions, such as patient anxiety or confusion, associated with patients' internet health information seeking. Two communicative strategies were identified: the participative and defensive approaches. While the former seeks to guide internet-informed patients to use internet information with physicians' expertise, the latter aims to discourage patients from using the internet to seek health information. Physicians' perceptions were linked to their strategies: those holding positive views tended to adopt a participative approach, while those with negative views favored a defensive strategy. Some physicians claimed to shift between the 2 approaches depending on their interaction with a certain patient. We also identified several challenges and needs of physicians in dealing with internet-informed patients, including the time pressure to address internet-informed patient demands, a lack of structured training, and being uninformed about trustworthy internet sites that can be recommended to internet-informed patients. CONCLUSIONS: This review highlights the diverse perceptions that physicians hold toward internet-informed patients, as well as the interplay between their perceptions, communication strategies, and their interactions with individual patients. Incorporating elements into the medical teaching curriculum that introduce physicians to reliable internet health resources for patient guidance, coupled with providing updates on technological advancements, could be instrumental in equipping physicians to more effectively manage internet-informed patients. TRIAL REGISTRATION: PROSPERO CRD42022356317; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=356317.

The Impact of COVID-19 and Exposure to Violent Media Content on Cyber Violence Victimization Among Adolescents in South Korea: National Population-Based Study.

BACKGROUND: Because of the COVID-19 pandemic and consequent stay-at-home mandates, adolescents faced isolation and a decline in mental health. With increased online activity during this period, concerns arose regarding exposure to violent media content and cyber victimization among adolescents. Yet, the precise influence of pandemic-related measures on experiences of cyber violence remains unclear. Hence, it is pertinent to investigate whether the pandemic altered the dynamics of cyber violence victimization for individuals. OBJECTIVE: This study aims to investigate the effects of COVID-19 and exposure to violent media content on cyber violence victimization among adolescents in South Korea. METHODS: We used national survey data from 2019 (n=4779) and 2020 (n=4958) to investigate the potential impact of COVID-19 on the prevalence of cyber violence among young adolescents. The data encompassed responses from elementary fourth-grade students to senior high school students, probing their exposure to violent media content, average internet use, as well as experiences of victimization and perpetration. RESULTS: The analysis revealed a noteworthy decline in cyber victimization during 2020 compared with 2019 (B=-0.12, t=-3.45, P<.001). Furthermore, being a perpetrator significantly contributed to cyber victimization (B=0.57, t=48.36, P<.001). Additionally, younger adolescents (ß=-.06, t=-6.09, P<.001), those spending more time online (ß=.18, t=13.83, P<.001), and those exposed to violent media (ß=.14, t=13.89, P<.001) were found to be more susceptible to victimization. CONCLUSIONS: Despite the widespread belief that cyber violence among adolescents surged during COVID-19 due to increased online activity, the study findings counter this assumption. Surprisingly, COVID-19 did not exacerbate cyber victimization; rather, it decreased it. Given the strong correlation between cyber victimization and offline victimization, our attention should be directed toward implementing real-life interventions aimed at curbing violence originating from in-person violence at school.

Influenza and Covid-19 Vaccination in 2023: a descriptive analysis in two Italian Research and Teaching Hospitals. Is the On-Site strategy effective?

Introduction: Vaccinations represent an extremely effective tool for the prevention of certain infectious diseases - such as influenza and COVID-19 -, particularly for those categories at risk due to both their frail condition or professional exposure, such as healthcare workers. The aim of this study is to describe the course of the anti-influenza and anti-COVID-19 vaccination campaign at two Research Hospitals in Milan, Italy. Study design: Multicentre, cross-sectional study. Methods: For the 2023-24 vaccination campaign, the two facilities opted for two different approaches. At the Hospital A, two dif-ferent strategies for vaccinating healthcare workers were implemented: a fixed-site vaccination clinic and two mobile vaccination groups run by Public Health residents of the University of Milan. At the Hospital B, on the other hand, a single fixed-site outpatient clinic run by Public Health residents of the University of Milan was used. On the occasion of the campaign, a survey was also carried out using anonymous online questionnaires to investigate healthcare workers attitudes towards vaccination. Results: A total of 1,937 healthcare workers were vaccinated: 756 were immunized against influenza only, 99 against COVID-19 only, and 1,082 against both. The results show a substantial difference in vaccination adherence among medical and nursing staff compared to other professional categories. In particular, the category with the highest vaccination adhesion turned out to be that of medical doctors with 55.7% adhesion while, on the contrary, the category with the lowest adhesion turned out to be that of auxiliary personnel characterized by 7.4% adhesion. At the same time, the comparison between the two hospital facilities showed a double adherence rate by the staff of Hospital A as regards both the flu vaccine (40.6% and 20.1%) and the anti-COVID-19 vaccine (26.4% and 12.3%). Finally, the survey showed that the attitude towards influenza vaccination is lower among auxiliary staff in terms of both knowledge and vaccination attitude. Conclusions: The results of the study show a vaccination adherence in line with that of previous years, although lower than the values recommended by the principal national and international Organizations. The analysis of the differences between the two facilities and the surveys carried out will allow for the implementation of targeted interventions to increase adherence in future campaigns.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy.

OBJECTIVES: This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance. METHODS: Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year. RESULTS: The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy. CONCLUSION: The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior. PRACTICE IMPLICATIONS: The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

Medication safety perceptions in China: Media exposure, healthcare experiences, and trusted information sources.

OBJECTIVE: Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS: A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS: Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS: Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.

Electronic Health Literacy Among Baby Boomers: A Typology.

BACKGROUND: Forecasts suggest that older adults will place unprecedented demands on future health care systems. Electronic health (eHealth) resources can potentially mitigate some pressures, but to be effective patients need to be able to use them. The negative relationship between eHealth literacy and age usually results in older adults classified as one homogenous mass, which misses the opportunity to tailor interventions. OBJECTIVE: This research examines similarities and differences within the baby boom cohort among a sample that uses the internet for health information. METHODS: We used an electronic survey with random samples of baby boomers (N = 996) from the United States, the United Kingdom, and New Zealand. KEY RESULTS: Four distinct subgroups, or segments, emerged. While not different from a socioeconomic perspective, these four groups have very different levels of eHealth literacy and corresponding health behaviors. Therefore, we contribute a more complex picture than is usually presented in eHealth studies. CONCLUSIONS: Resulting insights offer a useful starting point for providers wishing to better tailor health products, services, and communications to this large cohort of future older individuals. [HLRP: Health Literacy Research and Practice. 2024;8(1):e3-e11.].

PLAIN LANGUAGE SUMMARY: We researched the ability to find and use eHealth information among an international cohort of baby boomers. We identified four distinct groups whose use of ehealth differs considerably from each other. Findings give guidance to health care providers on how they can work with the different groups to encourage better health care management.

Linguistic and (micro)cultural differences in the global debate about re-naming 'schizophrenia': A mixed-methods survey from Switzerland.

BACKGROUND AND HYPOTHESIS: This survey explores Swiss mental health professionals', users', and relatives' opinions on re-naming schizophrenia exploiting Switzerland's specific multilingualism to examine possible effects of linguistic and microcultural differences on the issue. STUDY DESIGN: Opinions on 'schizophrenia' were collected using a self-rated online questionnaire incl. Freetext answers available in the three main Swiss languages, German, French and Italian. It was distributed to the main professional and self-help organizations in Switzerland between June and October 2021. STUDY RESULTS: Overall, 449 persons completed the questionnaire, 263 in German, 172 in French and 14 in Italian. Of the total sample, 339 identified as mental health professionals, 81 as relatives and 29 as users. Considering the whole sample, almost half favored a name-change with a significant difference between stakeholder- and between language groups. Also, the name 'schizophrenia' was evaluated more critically than the diagnostic concept. Qualitative analysis of freetext answers showed a highly heterogenous argumentation, but no difference between language groups. CONCLUSIONS: Our results suggest the attitude towards re-naming might itself be subject to (micro)cultural difference, and they highlight the nature of 'schizophrenia' as not only a scientific, but also a linguistic and cultural object. Such local factors ought to be taken into consideration in the global debate.

Risk Perception, Acceptance, and Trust of Using AI in Gastroenterology Practice in the Asia-Pacific Region: Web-Based Survey Study.

BACKGROUND: The use of artificial intelligence (AI) can revolutionize health care, but this raises risk concerns. It is therefore crucial to understand how clinicians trust and accept AI technology. Gastroenterology, by its nature of being an image-based and intervention-heavy specialty, is an area where AI-assisted diagnosis and management can be applied extensively. OBJECTIVE: This study aimed to study how gastroenterologists or gastrointestinal surgeons accept and trust the use of AI in computer-aided detection (CADe), computer-aided characterization (CADx), and computer-aided intervention (CADi) of colorectal polyps in colonoscopy. METHODS: We conducted a web-based questionnaire from November 2022 to January 2023, involving 5 countries or areas in the Asia-Pacific region. The questionnaire included variables such as background and demography of users; intention to use AI, perceived risk; acceptance; and trust in AI-assisted detection, characterization, and intervention. We presented participants with 3 AI scenarios related to colonoscopy and the management of colorectal polyps. These scenarios reflect existing AI applications in colonoscopy, namely the detection of polyps (CADe), characterization of polyps (CADx), and AI-assisted polypectomy (CADi). RESULTS: In total, 165 gastroenterologists and gastrointestinal surgeons responded to a web-based survey using the structured questionnaire designed by experts in medical communications. Participants had a mean age of 44 (SD 9.65) years, were mostly male (n=116, 70.3%), and mostly worked in publicly funded hospitals (n=110, 66.67%). Participants reported relatively high exposure to AI, with 111 (67.27%) reporting having used AI for clinical diagnosis or treatment of digestive diseases. Gastroenterologists are highly interested to use AI in diagnosis but show different levels of reservations in risk prediction and acceptance of AI. Most participants (n=112, 72.72%) also expressed interest to use AI in their future practice. CADe was accepted by 83.03% (n=137) of respondents, CADx was accepted by 78.79% (n=130), and CADi was accepted by 72.12% (n=119). CADe and CADx were trusted by 85.45% (n=141) of respondents and CADi was trusted by 72.12% (n=119). There were no application-specific differences in risk perceptions, but more experienced clinicians gave lesser risk ratings. CONCLUSIONS: Gastroenterologists reported overall high acceptance and trust levels of using AI-assisted colonoscopy in the management of colorectal polyps. However, this level of trust depends on the application scenario. Moreover, the relationship among risk perception, acceptance, and trust in using AI in gastroenterology practice is not straightforward.

A encruzilhada da nanotecnologia: inovação, tecnologia e riscos / The crossroads of nanotechnology innovation, technology and risk

O que é uma inovação tecnológica? O que vem a ser risco tecnológico? O que podemos esperar de fato da nanotecnologia? O que o passado nos ensina sobre tudo isso? Mais importante como podemos nos informar e criar opiniões sobre esses temas e decidir de maneira mais consciente o que pensar a respeito da nanotecnologia? E, afinal, qual é a relevância da percepção pública e de sua opinião nisso tudo? Esses temas são abordados neste livro, que se utiliza de exemplos de várias áreas do conhecimento.