"The dream is that there's one place you go": a qualitative study of women's experiences seeking care from Long COVID clinics in the USA.

BACKGROUND: Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic. METHODS: We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics. RESULTS: Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent. CONCLUSIONS: While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.

#EndtheSTIgma: An Exploratory Analysis of the 2019 HPV Awareness Day Conversation on Twitter & Instagram.

The current study explores the risk communication conversations on Twitter and Instagram in the context of the 2019 HPV Awareness Day, through the theoretical lenses of the stigma associated with HPV, HPV-related cancer, and the HPV vaccine. Our findings reveal that: 1) self and enacted stigma are present in these social media conversations, via nonprofits and official ambassadors, and via regular people; 2) other categories related to stigma, which can be seen as reactions to stigma and appeals to better individuals and society (i.e. stopping stereotypes) also emerged in these conversations, via official and not official sources, pro and against vaccine discourses; and 3) the same categories emerged from the data via both platforms, but differences exist in terms of narratives and messaging. Practical implications are discussed.

Reading, sharing, creating Pinterest recipes: Parental engagement and feeding behaviors.

Pediatric overweight and obesity are associated with serious health concerns both during childhood and in adulthood. Visual social media platform Pinterest is often used to curate recipe content, but little is known about how, if at all, parents use the platform as a resource for meal planning for their families. This study focused on (1) describing how Pinterest using parents use the platform related to recipe searches and meal planning and (2) examining the association between parental feeding behaviors and frequency of Pinterest use related to recipes. Survey research firm Qualtrics was used to collect a nationwide sample of 659 Pinterest-using parents with children between ages 3-11 years of age. Data collection was initiated and completed in February of 2019. Measures included both parent and child demographics, Pinterest recipe use and engagement, and parental feeding practices using the Child Feeding Questionnaire (CFQ). Results showed that 26.9% of the respondents reported using Pinterest daily to read recipes, 17.9% to share recipes; 14.9% to comment on recipes on Pinterest; 10.3% reported creating and posting new recipes; and 13.8% mentioned making a recipe they find on Pinterest daily. Pinterest engagement was significantly negatively associated with parental age and with income insecurity, while positively associated with level of education. Hispanic participants showed higher levels of engagement as compared to White non-Hispanic participants. Among the CFQ subscales, Pressure and Perceived responsibility were significantly positively associated with Pinterest engagement while Monitoring and Restriction were not.

Tweeting a Pandemic: Communicating #COVID19 Across the Globe.

The COVID-19 pandemic brought about an urgent need for public health departments to clearly communicate their prevention, testing, and treatment recommendations. Previous research supports that Twitter is an important platform that public health departments use to communicate crisis information to stakeholders. This study aimed to shed light on how international health departments shared relevant information about COVID-19 on Twitter in 2020. We conducted a quantitative content analysis of N = 1,200 tweets from twelve countries, across six continents. COVID-19 prevention behaviors were consistently referenced far more than testing or treatment recommendations across countries. Disease severity and susceptibility were referenced more than recommendation benefits, barriers, and efficacy. Results provide support for how public health departments can better communicate recommendations related to COVID-19 behaviors. Based on these results, implications for public health organizations and public relations practitioners worldwide are discussed, and hands-on action guidelines are provided.

#Arabhealth on Instagram: Examining Public Health Messages to Arabian Gulf State Audiences.

Instagram is a social media platform used for communicating health information to audiences in the member states of the Gulf Cooperation Council (GCC), but little is known about the specific use of the platform for this purpose. This study, focused on 1,000 Instagram posts by the GCC Ministries of Health, analyzed how public health information is discussed differently across the GCC on Instagram, as well as the extent to which Health Belief Model (HBM) variables - a frequently used health behavior theory focused on understanding individual adoption of certain health behaviors - are present in these posts. Results showed that a majority of messages did not include HBM constructs other that perceived benefits and calls to action, limiting their potential for effective public health communication. Results also showed a minority of posts deal with mental health. Recommendations for future best practices are discussed.

Pinning Pink: Messages About Hereditary Breast Cancer Risk on Pinterest.

Social media messages and conversations provide an opportunity to study what users post about cancer risk and preventive behaviors. Personal stories of early detection, treatment, and survivorship are often shared. The purpose of this study was to examine the hereditary breast cancer-focused posts on the understudied visual social media platform Pinterest. Using systematic random sampling, n = 500 Pinterest posts (referred to as "pins") were collected using the keywords "breast cancer" and "genetic testing" in the late 2017. Using a quantitative content analysis, pins were coded for a variety of categories including poster identity, pin characteristics and content, the presence of Health Belief Model constructs, and engagement variables (i.e., repins/saves and comments). The primary findings of this study reveal that most pins were published by individuals and relatively few messages contained specific information about genetic testing. Study results also describe how Pinterest users interact with the content, including higher engagement with information-rich visuals and traditional breast cancer awareness symbols. The information gained from this study may serve as the foundation for better understanding how social media can be used to communicate with women about heritable breast health-related cancers, risks, and protective behaviors. Study results prompt practical recommendations for public health organizations interested in reaching women seeking information about heritable breast cancer on Pinterest.

COVID-19-Related Misinformation among Parents of Patients with Pediatric Cancer.

We conducted a survey among 735 parents to determine differences in endorsement of misinformation related to the coronavirus disease pandemic between parents of children in cancer treatment and those with children who had no cancer history. Parents of children with cancer were more likely to believe misinformation than parents of children without cancer.

HPV Vaccine Searches on Pinterest: Before and After Pinterest's Actions to Moderate Content.

Objectives. To compare how human papillomavirus (HPV) vaccination was portrayed on Pinterest before and after the platform acted to moderate vaccine-related search results to understand (1) what the information environment looked like previously and (2) whether Pinterest's policy decisions improved this environment in terms of sources and content.Methods. In this quantitative content analysis, we compared 2 samples of 500 HPV vaccine-focused Pinterest posts ("pins") collected before and after Pinterest's actions to provide more reliable vaccine-related information. Pins were based on search results and were analyzed using the Health Belief Model.Results. The majority of preaction search results leaned toward vaccine skepticism, specifically focused on perceived vaccine barriers. Few pins were published by public health-related Pinterest accounts. Postaction search results showed a significant shift to HPV vaccination benefits, and the number of pins by government or medical accounts increased. However, the proportion of pins in search results containing HPV content of any type was significantly lower.Conclusions. Pinterest's efforts to moderate vaccination discussions were largely successful. However, the ban also appeared to limit HPV vaccination search results overall, which may contribute to confusion or an information vacuum.

#BeTheMatch: Assessing How Testimonials on Reddit Promote the Importance of Donating Bone Marrow.

This study explores how sharing testimonials on the social media network Reddit may encourage individuals to donate bone marrow. The theory of planned behavior guided a quantitative content analysis of 1,015 Reddit comments about donation. Research questions asked how individuals post about donation and how Redditors engage with this content. Overall, comments addressed more positive than negative outcome, efficacy, and normative beliefs. Comments that discussed beliefs related to registering to donate and the process of donating received significantly higher engagement than other comments. Additionally, comments that included positive outcome beliefs related to registering, positive efficacy beliefs related to registering and donating, and positive normative beliefs related to donating received higher engagement than other comments. Results suggest testimonials may be most effective if they focus on behavior facilitators and if they present donation as a positive norm deviant behavior. Finally, the Reddit forums functioned as places for individuals to seek out and share information. Comments included calls to action and hyperlinks for health resources. This research reveals how organic conversations on Reddit may promote health information seeking and advocacy behavior adoption. Implications for the theory of planned behavior and the use of Reddit as a platform for health promotion are discussed.

Tweeting about #Diseases and #Publichealth: Communicating Global Health Issues across Nations.

Twitter is playing an increasing role in health communications, but little is known about the Twitter use of national health departments in general and across different nations in particular. This quantitative content analysis of 1,200 tweets from 12 national health departments showed that the topics covered in these tweets are often lacking in broad coverage - cardiovascular disease is barely mentioned, while infectious diseases are often highlighted - and the tweets do not try to initiate engagement through creating a two-way dialogue with followers. However, the tweets appear to use Health Belief Model constructs, such as initiating cues to action, mentioning self-efficacy and highlighting perceived benefits of health preventative, treatment or screening options, and this is associated with increased Twitter engagement. The paper ends with recommendations for both future studies and new challenges for the use of Twitter by national health departments.

The skills required for entry-level public relations: An analysis of skills required in 1,000 PR job ads.

Preparing professionals to work in any industry means linking educational competencies and career requirements. With its own career-defining skills, the field of public relations is no different. Knowing the demands of the industry creates an opportunity to supply the most relevant education that gets early professionals hired. By analyzing 1000 job postings, this study unearths the most frequently requested entry-level public relations job skills by employers. While the study reaffirms the relevance of traditional skills like written communication, it also highlights advancing skills in digital and social media. It further demonstrates a clear call for soft skills like organizational skills, leadership abilities and ability to work in teams.

Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications.

We analyzed Instagram posts about Zika by using the Health Belief Model. We found a high presence of threat messages, yet little engagement with these posts. Public health professionals should focus on posting messages to increase self-efficacy and benefits of protective behavior, especially when a vaccine becomes available.

Making "Weedish Fish": An Exploratory Analysis of Cannabis Recipes on Pinterest.

Background: The expansion of legalized medical and recreational cannabis has created growing interest in cannabis infused edibles. Information about the preparation of edibles is readily available to the public on social media with little to no oversight. Objectives: To determine how recipes for cannabis edibles are promoted on the social media platform Pinterest. Methods: We performed a content analysis of 500 cannabis edible recipe pins collected in December 2017. Pins were coded for promotional content, user engagement, recipe presence and type, cannabis dosage and serving size, and presence of health and risk information. Results: A plurality of pins showed visuals of cannabis content (47.8%), and pins frequently depicted images of desserts infused with cannabis (40.0%). Almost half of all of pins (46.8%) included or linked out to a recipe for edibles, with recipes for desserts and baked goods being most common (40.0%). Cannabis dosages and serving sizes were often vague or missing, and health and safety warnings were almost entirely absent from pins. Conclusion/importance: Recipes for cannabis edibles are easily accessible through Pinterest. Information about dosage, serving size, health effects, and responsible usage are all but absent. Pins largely originate in locations where cannabis is legalized; however, content is accessible without regard to state or national borders. Public health agencies and organizations should consider publishing information about health effects and responsible usage that flow parallel to social media content promoting edibles.

Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers.

Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.

Adding COVID to cancer: does cancer status influence COVID-19 infection preventive behaviors?

Introduction: A better understanding of how to promote disease mitigation and prevention behaviors among vulnerable populations, such as cancer survivors, is needed. This study aimed to determine patterns of and factors associated with COVID-19-related preventive behaviors among cancer survivors and assess whether the COVID-19 preventive behaviors of cancer survivors differ from the general population. Methods: In June 2020, an online survey of adults (N = 897) assessed predictors of COVID-19-related preventive behaviors, including socio-demographics, COVID-19 beliefs and perceptions (Health Belief Model [HBM] variables), and cancer statuses (cancer survivors currently in treatment, cancer survivors not currently in treatment, and individuals with no history of cancer). An average score of respondent engagement in eight preventive behaviors was calculated. Differences in HBM variables and preventive behaviors by cancer status were assessed using ANCOVAs. Hierarchical multiple regression analyzed associations among socio-demographics, HBM constructs, cancer statuses, and engagement in COVID-19 preventive behaviors. Results: Participants reported engaging in 3.5 (SD = 0.6) preventive behaviors. Cancer survivors not in treatment engaged in preventive behaviors significantly less than the comparison group. In the final adjusted model, after adding COVID-19 beliefs and perceptions, cancer status was no longer significant. All HBM constructs except perceived susceptibility were significant predictors of preventive behaviors. Conclusions: COVID-19 beliefs and perceptions were more robust predictors preventive behaviors than cancer status. Nonetheless, public health organizations and practitioners should communicate the risk and severity of infection among cancer survivors and emphasize the need to engage in protective behaviors for COVID-19 and other infectious diseases with this vulnerable population.

Barriers and Facilitators of Colorectal Cancer Screening During the COVID-19 Pandemic.

BACKGROUND: COVID-19 introduced new barriers to health care including cancer screenings. This study evaluated the role of pandemic- and copay-related barriers to colonoscopy and the extent to which home-based testing methods were utilized. METHODS: A cross-sectional survey assessed colorectal cancer (CRC) attitudes and screening early in the COVID-19 pandemic. RESULTS: Respondents (342; 50.37% female) were 62.32 (SD = 6.87) years old. Roughly half were White/Caucasian (329; 48.45%); 29.75% were Black/African American (202); and 21.80% were another race (148). Roughly two-thirds were up-to-date with CRC screening (459; 67.59%). In an adjusted model, those with a higher agreement that concerns about COVID-19 delayed scheduling their colonoscopy (OR = .79; 95% CI: .08, .63; P = .045) and concerns about copays delayed scheduling their colonoscopy (OR = .73; 95% CI: .73, .57; P = .02) were less likely to be up-to-date on screening. In another adjusted model, those screened during the pandemic were significantly more likely to be screened via an at-home test (OR = 10.93; 95% CI: 5.95, 20.27; P < .001). DISCUSSION: During the COVID-19 pandemic, screening copay-related concerns persisted and were significantly higher among those not up-to-date with CRC screening. Increased at-home testing and addressing copay barriers may increase CRC screening adherence now and in future infectious disease outbreaks.

Oh Baby! A Content Analysis of Contraception Pins on Pinterest.

BACKGROUND: Social media platforms have become a popular source for health information despite concerns about the quality of content shared. We examined how oral contraceptive pills and intrauterine devices are framed on the platform Pinterest using the Health Belief Model (HBM), as well as how fertility awareness methods are portrayed as an alternative to hormonal contraception. METHODS: We collected pins in February 2021 using searches for birth control, oral contraceptives, and intrauterine devices. After excluding paid ads and pins not relevant to contraceptive use, we conducted a content analysis of 404 pins using a coding framework grounded in the HBM. We carried out descriptive statistics for all variables in the final sample. RESULTS: Following coding, we found that 54.7% of pins mentioned oral contraceptive pills, 41.58% mentioned intrauterine devices, and 11.63% mentioned fertility awareness methods. Fertility awareness pins had the highest percentage of benefits conveyed (70.21%), followed by intrauterine devices (44.05%), then oral contraceptive pills (38.91%). Pill pins had the highest percentage of barriers conveyed (52.94%) and fertility awareness had the least (25.53%). Side effects were the most mentioned barrier among pill (37.10%) and intrauterine device pins (23.21%). Very few pins were made by (2.48%) or originated with medical institutions (5.45%). CONCLUSIONS: Oral contraceptive pills are often negatively framed on Pinterest, whereas intrauterine devices and fertility awareness methods are more positively framed. This suggests a need for clear communication from clinicians regarding all contraceptive options and their relative merits and risks.

Older adults' exposure to and posting of health-related messages on Facebook by chronic health condition status.

Objective: Older adults may be particularly interested in health-related content on Facebook, especially those who have chronic health conditions. The purpose of this study was to compare older adult Facebook users with and without a chronic health condition on their frequency of posting and exposure to health-related content. Methods: Participants, recruited via Qualtrics, were regular Facebook users aged 50 + years. Participants were asked separately if they had seen, posted, and shared: Health-related information; about others'/their own health behaviors (e.g., exercise); and about others'/their own medical condition. Six logistic regression models, controlling for demographics and Facebook login frequency, were run to assess whether viewing and/or posting health-related messages differed by chronic health condition status. Results: Respondents (N = 697; 77.9% female) were on average 61.2 (SD = 7.9) years old and (n = 625; 89.7%) were White. One-half reported a chronic health condition (n = 351; 50.4%). In adjusted models, those with a chronic health condition had a higher likelihood of seeing posts containing health information (OR = 1.41; 95% CI: 1.04, 1.93) and about others' medical conditions (OR = 1.67; 95% CI: 1.22, 2.27) at least once a month compared to those with no chronic health conditions. People with and without chronic health conditions did not differ in terms of how often they see others' post about health behaviors. Those with a chronic health condition had a higher likelihood of posting or sharing health information (OR = 1.67; 95% CI: 1.22, 2.27), posting about their own health behaviors (OR = 1.55; 95% CI: 1.00, 2.44; p = 0.048), and about their health condition (OR = 1.96; 95% CI: 1.17, 3.27) at least once a month. Conclusion: Most older adults on Facebook are exposed to and post multiple forms of health-related content. Therefore, Facebook may be an appropriate channel for conducting health-related communication targeting older adults.

Mental health disorder symptom prevalence and rates of help-seeking among University-Enrolled, emerging adults.

Objective. Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students. Participants. 2500 students from an ongoing, student survey at a public university; launched in 2011. Methods. Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates. Results. Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p < 0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p < 0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024). Conclusion. Black men report depressive and anxiety symptoms but underutilize campus health resources.