Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study.

BACKGROUND: Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus. METHODS: A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes. RESULTS: The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (ß = 0.137, p = 0.029) and utilizing health information from applications (ß = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information. CONCLUSION: The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.

[Use of social networks as a source of information on health and digital health literacy in the Spanish general population]. / Uso de redes sociales como fuente de información sobre salud y alfabetización digital en salud en población general española.

OBJECTIVE: Social media allows individuals to access a vast amount of health-related information immediately and anonymously, a fact that is turning these platforms into one of the primary sources of reference in this area, especially for younger generations. Given this reality, the objective of determining the impact of social media on digital health literacy in the general Spanish population was proposed. METHODS: A cross-sectional descriptive study was carried out in 2023. Using a non-probabilistic sampling, the population residing in Spain, over eighteen years old, and users of social networks were included, obtaining a sample of 1,307 participants. An adaptation of the validated eHEALS questionnaire on digital health literacy was used. This questionnaire, created in Microsoft Forms, was disseminated through an anonymous link via the research team's social networks and collaborators. A descriptive and inferential statistical analysis was performed using SPSS 22.0, assuming a significance level with a value of p<0.05. RESULTS: All participants affirmed having consumed health information through social networks, but 72.1% stated they had actively used these platforms to search for this health information. Regarding digital health literacy, a median score of 24 out of 40 points was obtained on the questionnaire, being significantly higher among those who claimed to use social networks as a source of health information (p=0.0001). CONCLUSIONS: Actively employing social media as a source of health information is associated with a higher level of digital health literacy.

OBJECTIVE: Las redes sociales permiten a las personas acceder de manera inmediata y anónima a una cantidad ingente de información sobre aspectos de salud, hecho que está provocando que se estén convirtiendo en una de las fuentes de referencia en este ámbito, sobre todo para las generaciones más jóvenes. Atendiendo a esta realidad se planteó el objetivo de determinar el impacto de las redes sociales en la alfabetización digital en salud en la población general española. METHODS: Se realizó un estudio descriptivo transversal en el año 2023. Mediante un muestreo no probabilístico, se incluyó población residente en España, mayor de dieciocho años y usuaria de redes sociales, obteniendo una muestra de 1.307 participantes. Se utilizó una adaptación del cuestionario validado eHEALS sobre alfabetización digital en salud. Dicho cuestionario, elaborado en Microsoft Forms, fue difundido mediante un enlace anónimo a través de las redes sociales del equipo investigador y colaboradores. Se realizó un análisis estadístico descriptivo e inferencial mediante SPSS 22.0, asumiendo un nivel de significación con un valor de p<0,05. RESULTS: La totalidad de los participantes afirmaron haber consumido información sobre salud a través de redes sociales, pero fue el 72,1% el que afirmó haber usado estas plataformas activamente para buscar esta información sobre salud. Con respecto a la alfabetización digital en salud, se obtuvo una puntuación mediana en el cuestionario de 24 sobre 40 puntos, siendo significativamente mayor entre los que afirmaron usar las redes sociales como fuente de información sobre salud (p=0,0001). CONCLUSIONS: Emplear de manera activa las redes sociales como fuente de información sobre salud parece tener relación con un mayor nivel de alfabetización digital en salud.

Assessment of internet-based information on statin therapy.

AIMS: The use of statin therapy is deemed to be controversial by mainstream media. Patients increasingly source medical information from the internet, and the use of statins is no exception. This study aims to determine the quality and educational content of statin-focused information on the internet and YouTube. METHODS AND RESULTS: 'Statin' was searched on Google, Yahoo!, Bing, and YouTube. The first 50 results obtained from each search engine and the first 20 YouTube videos were screened by two assessors. Websites were assessed using the Flesch Reading Ease (FRE) score, University of Michigan Consumer Health Website Evaluation Checklist, and a customized scoring system evaluating statin-focused content for quality. Videos were scored using the Journal of the American Medical Association (JAMA) benchmark criteria, Global Quality Score (GQS), and the customized scoring system. Websites scored a median FRE score of 57.5 [interquartile range (IQR) 52.1-62.3], median Michigan score of 36 (IQR 32-41.5), and median content score of 5 (IQR 3.75-7). Good interobserver agreement was demonstrated [Michigan score interobserver coefficient correlation (ICC) = 0.968; content score ICC = 0.944]. Videos scored a median JAMA score of 2, median GQS score of 2.5, and median content score of 2.5. Good interobserver agreement was demonstrated (JAMA ICC = 0.746; GQS ICC = 0.874; content score ICC = 0.946). CONCLUSION: Quality and readability of statin-focused online information are poor. Healthcare professionals should be aware of the limitations of the current available sources and design online resources that are accurate and patient-friendly.

Readability and Quality of Online Information on Sickle Cell Retinopathy for Patients.

PURPOSE: This study aims to evaluate the readability and quality of Internet-based health information on sickle cell retinopathy. DESIGN: Retrospective cross-sectional website analysis. METHODS: To simulate a patient's online search, the terms "sickle cell retinopathy" and "sickle cell disease in the eye" were entered into the top 3 search engines (Google, Bing and Yahoo). The first 20 results of each search were retrieved and screened for analysis. The DISCERN questionnaire, the Journal of the American Medical Association (JAMA) standards, and the Health on the Net (HON) criteria were used to evaluate the quality of the information. The Flesch-Kincaid Grade Level (FKGL), the Flesch Reading Ease (FRES), and the Automated Readability Index (ARI) were used to assess the readability of each website. RESULTS: Of 16 online sources, 12 (75%) scored moderately on the DISCERN tool. The mean DISCERN score was 40.91 (SD, 10.39; maximum possible, 80). None of the sites met all of the JAMA benchmarks, and only 3 (18.75%) of the websites had HONcode certification. All of the websites had scores above the target American Medical Association grade level of 6 on both the FKGL and ARI. The mean FRES was 57.76 (±4.61), below the recommended FRES of 80 to 90. CONCLUSION: There is limited online information available on sickle cell retinopathy. Most included websites were fairly difficult to read and of substandard quality. The quality and readability of Internet-based, patient-focused information on sickle cell retinopathy needs to be improved.

Public's preferences for health science popularization short videos in China: a discrete choice experiment.

Background: Health science popularization short video disseminates health information to the public in an understandable way about health information. Objective: To investigate the preferences of Chinese residents for health science popularization short videos and provide suggestions for optimizing the production of short videos. Methods: An online survey of Chinese people was conducted using a self-administered questionnaire, and a discrete choice experiment (DCE) was used to explore the public's preferences for health science popularization short videos. Results: A total of 618 respondents were included, of which 306 (45.51%) were male and 312 (50.49%) were female, 271 (43.85%) were aged 18-25, 239 (38.67%) were aged 26-60, and 108 (17.48%) were aged 60 and above. Whether the video is charged or not (46.891%) and the account subject (28.806%) were both considered important. The results of the DCE revealed that the participants considered video free of charge as the most significant attribute of health science popularization short videos (OR 3.433, 95% CI 3.243-3.633). Overall, participants preferred and were more willing to pay for health science popularization short videos with a hospital account subject (OR 1.192, 95% CI 1.116-1.274), with the form of graphic narration (OR 1.062, 95% CI 1.003-1.126), free of charge (OR 3.433, 95% CI 3.243-3.633), with the content that satisfies their needs (very much needed: OR 1.253, 95% CI 95% CI 1.197-1.311; generally needed: OR 1.078, 95% CI 1.029-1.129), with platform certification (OR 1.041, 95% CI 1.011-1.073), without commercial advertisements (OR 1.048, 95% CI 1.018-1.080), with simple-to-understand content (OR 1.071, 95% CI 1.040-1.104), and with video content that evokes fear or dread of illness in the viewer (OR 1.046, 95% CI 1.015-1.078). Conclusion: Participants favor free health popularization short videos, which are hospital accounts, with content that is illustrated, understandable, meets their needs, and can serve as a warning. In the future, the production of health popularization short videos should focus on improving the diversity and relevance of video content, making it as easy to understand to achieve good science popularization effects.

Douyin as a source of information and education on humeral supracondylar fracture of children during the COVID-19 pandemic in Chinese Mainland: An observational study.

We aimed to investigate whether Douyin videos on pediatric humeral supracondylar fractures could be a useful source during the COVID-19 pandemic. A search was conducted using the term "humeral supracondylar fracture of children" on Douyin. The top 100 videos were selected based on view count. 74 was the final analysis, after excluding 26 videos for various reasons. First, the videos were classified into medical and the non-medical groups based on authorship. The medical team videos were about explanations or detailed surgical procedures directly related to child's fracture. There were also non-medical videos, mostly about personal experiences and other things. The videos were then also divided into 2 groups abased on the year of COVID-19 pandemic. The number of views, content type, video duration and number of likes about the video were analyzed. Among the 74 videos included in this study, had a total of 19,647,988 views (median 205,129, range 7874-1,495,004). Compared to the medical group, the non-medical group had more views (P = .004), likes (P = .000), view ratio (P = .019), and video power index (P = .024). During the COVID-19 pandemic, views (P = .033), view ratio (P = .006), and video power index (P = .043) also increased. Douyin has been a valuable source of health information for patients during COVID-19 pandemic regarding the occurrence of humeral supracondylar fracture in children. Medical professionals and institutions should upload credible, informative videos and clear, high-quality, scientifically reviewed surgical footage of children with humeral supracondylar fracture. And the videos uploaded by medical professionals and filtered by Douyin's staff appear to be necessary.

Appropriateness of Cardiovascular Disease Prevention Recommendations Obtained From a Popular Online Chat-Based Artificial Intelligence Model.

This study examines the appropriateness of artificial intelligence model responses to fundamental cardiovascular disease prevention questions.

Dr Google - assessing the reliability and readability of information on general surgical procedures found via search engines.

BACKGROUND: The most common general surgical emergency operations are laparoscopic appendicectomy, laparoscopic cholecystectomy, hernia repair, hemorrhoidectomy and colectomy. Patients commonly perform an internet search for more information prior to undergoing surgery, which can lead to an inappropriate understanding of their procedure. The aim is to assess the quality of information available on three of the most used search engines. METHODS: A search was conducted on Google.com, Bing.com and Yahoo.com using the terms related to laparoscopic appendicectomy, laparoscopic cholecystectomy, hemorrhoidectomy, hernia repair and colectomy. First 20 results from each search engine were collected for evaluation. Results were excluded if they were sponsored, duplicates, academic publications, advertisements, forums, audiovisual tools, social media or any non-English information. Included results were assessed for reliability using DISCERN and JAMA benchmark score. Readability was assessed using Flesch Reading Ease (FRE) Score and Simple Measure of Gobbledygook (SMOG). RESULTS: Hundred and ninety-seven websites were analysed, 44.7% were published by institutions, 34.5% by health websites and 20.8% by independent surgeons. Mean DISCERN scores for Institutions was 54.6 ± 11.3, independent surgeons 45.9 ± 11.4 and health websites 58.7 ± 10.3. Mean JAMA score for Institutions was 1.0 ± 1.0, independent surgeons 0.1 ± 0.4 and health websites 1.7 ± 1.1. FRE scores for institutions was 51.6 ± 10.3, independent surgeons 40.9 ± 10.2, and health websites 45.7 ± 12.3. SMOG scores were 9.8 ± 1.5 for institutions, 11.4 ± 1.6 for independent surgeons and 10.6 ± 1.7 for health websites. CONCLUSION: Health information on common general surgical procedures found on search engines are generally fair to good quality but still above the suggested reading level of the population. Information on surgical procedures should be written at recommended reading level of 13-14 years old.

Readability, reliability and credibility of online patient information on skin grafts.

BACKGROUND: Skin grafting reflects a common dermatological procedure for closing skin defects. Patient education is important for managing expectation and optimising skin graft take. While health information is increasingly accessed on the internet, there are no existing studies assessing their quality. METHODS: The first 25 results from Google, Microsoft Bing and Yahoo! search engines using the term 'skin graft' were analysed using a variety of standard instruments. Readability was assessed using the Flesch-Kincaid Grade score (FKG), Gunning Fog Index (GFI), Simple Measure of Gobbledygook (SMOG) and the New Dale-Chall Readability Index (NDC). Reliability was assessed using the DISCERN instrument and credibility with the Journal of the American Medical Association Benchmark Criteria (JAMA). Transparency was identified by presence of the Health On the Net Foundation Code certification (HON-code). RESULTS: Seventy-five websites were identified. After exclusion, forty-three remaining websites were analysed with average FKG, GFI and SMOG scores of 7.8, 10.1 and 10.7, respectively. The average NDC was 5.9. The average reliability was fair with a DISCERN score based on the first 15 questions of the instrument of 42.6. The mean JAMA score was 2, and 9 websites displayed the HON-code certificate. CONCLUSIONS: Readability, reliability and credibility of online health information regarding skin grafting can be improved. Health care providers should critically assess existing online patient information or develop alternative material to educate patients undergoing skin graft surgery.

Reliability of online pregnancy-related information and associated feelings of worry among expectant women in Qatar.

BACKGROUND: Although the internet can be a source of reassurance and clarification for expectant women, it could cause concerns or feelings of worry when reading about pregnancy-related information. This research study sought to assess feelings of worry and perceived reliability of online pregnancy-related information and the associated factors among expectant women attending antenatal clinics at primary healthcare centers in Qatar. METHODS: A cross-sectional study design was used. The participants were recruited through a systematic random sampling technique. A self-administered questionnaire was used to collect data from the participants. Descriptive and analytic statistics were used as appropriate. RESULTS: A total of 327 expectant women completed the questionnaire. Most were aged between 26-34 years (74.1%), held a college/university degree (76.4%), and were multigravidas (73.1%). About one-third of the women (31.2%) reported feeling worried due to information they read online. They coped with these feelings by consulting their antenatal care provider at their next appointment (51.0%) or by talking with relatives and friends (47.0%). Most participants (79.2%) considered online pregnancy-related information to be reliable or highly reliable. Holding a college/university degree and being primigravidae were factors significantly associated with a high perception of reliability of online pregnancy information. CONCLUSION: Although online pregnancy information caused feelings of worry for some expectant women, most perceived such information to be reliable. Thus, antenatal care providers should guide expectant women on how to access high-quality web-based information.

Readability and quality of online information for patients pertaining to revision knee arthroplasty: An objective analysis.

BACKGROUND: Modern patients use the internet more frequently for their health information. Our aim was to assess the quality and readability of online patient education materials relating to revision knee arthroplasty. We hypothesised that this information would be too difficult to read for the average patient and of a lesser quality than desired. METHOD: A search of the top 50 results on 3 search engines (Google, Bing, Yahoo) was completed (MeSH "revision knee arthroplasty", "revision knee replacement"). Readability of these websites was calculated using a specialised website, www.readable.com to produce 3 scores (Gunning-Fog (GF), Flesch Reading Ease (FRE), Flesch-Kincaid Grade (FKG). Quality was assessed using the Journal of American Medical Association (JAMA) benchmark criteria and the Health On the Net (HON) code toolbar extension. RESULTS: 89 unique websites were identified. Mean FRE was 44.01 ± 11.05. The mean GF was 12.01 ± 2.94. The mean FKG level was 10.06 ± 1.95. As per the FRE score, no webpage was pitched at or below a sixth grade reading level. The GF index identified only 3 websites (3.4%) at 6th grade reading level. As per FKG score, most webpages (n = 58, 65.2%) found themselves in the 10th grade reading level and above. Four websites (4.5%) displayed a HONcode certificate. However, all had expired. Most websites (n = 34, 38.2%) didn't meet any of the JAMA criteria. CONCLUSION: The reading level of these materials is too high for the average patient and of a low quality. Given what we know about levels of health literacy and their relationship with patient outcomes, it is vital that we address these deficiencies promptly.

The Patient Navigator: Can a systematically developed online health information tool improve patient participation and outcomes related to the consultation in older patients newly diagnosed with colorectal cancer?

BACKGROUND: Older cancer patients may search for health information online to prepare for their consultations. However, seeking information online can have negative effects, for instance increased anxiety due to finding incorrect or unclear information. In addition, existing online cancer information is not necessarily adapted to the needs of older patients, even though cancer is a disease often found in older individuals. OBJECTIVE: The aim of this study was to systematically develop, implement and evaluate an online health information tool for older cancer patients, the Patient Navigator, providing information that complements the consultation with healthcare providers. METHOD: For the development and evaluation of the Patient Navigator, the four phases of the MRC framework were used. In the first and second phase the Patient Navigator was developed and pilot tested based on previous research and sub-studies. During the third phase the Patient Navigator was implemented in four Dutch hospitals. In the last phase, a pilot RCT was conducted to evaluate the Patient Navigator in terms of usage (observational tracking data), user experience (self-reported satisfaction, involvement, cognitive load, active control, perceived relevance of the tool), patient participation (observational data during consultation), and patient outcomes related to the consultation (questionnaire data regarding anxiety, satisfaction, and information recall). Recently diagnosed colorectal cancer patients (N = 45) were randomly assigned to the control condition (usual care) or the experimental condition (usual care + Patient Navigator). RESULTS: The Patient Navigator was well used and evaluated positively. Patients who received the Patient Navigator contributed less during the consultation by using less words than patients in the control condition and experienced less anxiety two days after the consultation than patients in the control condition. CONCLUSION: Since the Patient Navigator was evaluated positively and decreased anxiety after the consultation, this tool is potentially a valuable addition to the consultation for patients. Usage of the Patient Navigator resulted in patients using less words during consultations, without impairing patients' satisfaction, possibly because information needs might be fulfilled by usage of the Patient Navigator. This could create the possibility to personalize communication during consultations and respond to other patient needs.

A Mixed Methods Population Health Approach to Explore Radon-Induced Lung Cancer Risk Perception in Canada.

BACKGROUND: Radon is a predominant indoor air pollutant and second leading cause of lung cancer in radon-prone areas. Despite the gravity of the health risk, residents in Canada have inadequate perception and taken minimal protective actions. Better perception of a risk motivates people to take preventive measures. Scholarship about radon health risk perception is lacking in Canada. We applied a mixed methods population health approach to explore the determinants shaping perception and actions of a resident population in Canada. METHODS: We conducted mixed surveys (n = 557) and qualitative bilingual interviews (n = 35) with both homeowners and tenants of Ottawa-Gatineau areas. The study explored residents' risk perception and adaptations factors. Descriptive, correlational and regression analyses described and established associations between quantitative variables. Thematic, inductive analyses identified themes in the qualitative data. A mixed methods analysis triangulated both results to draw a holistic perception of the health risk. RESULTS: Residents' quantitative perceptions of radon health risk, smoking at home, synergistic risk perception, social influence and care for family were associated significantly with their intention to test for radon levels in their home, actual testing and mitigation. These results were explained further with the qualitative findings. Residents who had dual cognitive and emotional awareness of the risk were motivated enough to take preventive actions. Caring for family, knowing others who contracted lung cancer and financial capability were enablers, whereas lack of awareness and homeownership, cost of mitigation and stigma were obstacles to preventive actions. We also explored the dual subjective and objective aspects of risk perception that are influenced by micro- and macro-level determinants. CONCLUSIONS: Inducing protective action to reduce risk requires comprehensive population-level interventions considering dual perceptions of the risk that can modify the risk determinants. Future research can explore the dual aspects of risk perception and unequal distribution of the risk factors.

Family-Based Obesity Prevention Interventions among Hispanic Children and Families: A Scoping Review.

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.

Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study.

BACKGROUND: Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). METHODS: This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. RESULTS: Patients on PD had a significantly higher BHLS'score than patients on ICHD (p = 0.04). HLQ's scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). CONCLUSION: In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

Hesitancy Toward a COVID-19 Vaccine.

The scientific community has come together in a mass mobilization to combat the public health risks of COVID-19, including efforts to develop a vaccine. However, the success of any vaccine depends on the share of the population that gets vaccinated. We designed a survey experiment in which a nationally representative sample of 3,133 adults in the USA stated their intentions to vaccinate themselves and their children for COVID-19. The factors that we varied across treatments were: the stated severity and infectiousness of COVID-19 and the stated source of the risk information (White House or the Centers for Disease Control). We find that 20% of people in the USA intend to decline the vaccine. We find no statistically significant effect on vaccine intentions from the severity of COVID-19. In contrast, we find that the degree of infectiousness of the coronavirus influences vaccine intentions and that inconsistent risk messages from public health experts and elected officials may reduce vaccine uptake. However, the most important determinants of COVID-19 vaccine hesitancy seem to be distrust of the vaccine safety (including uncertainty due to vaccine novelty), as well as general vaccine avoidance, as implied by not having had a flu shot in the last two years.

Digital Health Engagement in the US Population: Insights From the 2018 Health Information National Trends Survey.

Objectives. To examine prevalence and predictors of digital health engagement among the US population. Methods. We analyzed nationally representative cross-sectional data on 7 digital health engagement behaviors, as well as demographic and socioeconomic predictors, from the Health Information National Trends Survey (HINTS 5, cycle 2, collected in 2018; n = 2698-3504). We fitted multivariable logistic regression models using weighted survey responses to generate population estimates. Results. Digitally seeking health information (70.14%) was relatively common, whereas using health apps (39.53%) and using a digital device to track health metrics (35.37%) or health goal progress (38.99%) were less common. Digitally communicating with one's health care providers (35.58%) was moderate, whereas sharing health data with providers (17.20%) and sharing health information on social media (14.02%) were uncommon. Being female, younger than 65 years, a college graduate, and a smart device owner positively predicted several digital health engagement behaviors (odds ratio range = 0.09-4.21; P value range < .001-.03). Conclusions. Many public health goals depend on a digitally engaged populace. These data highlight potential barriers to 7 key digital engagement behaviors that could be targeted for intervention.

Scratching the surface: a review of online misinformation and conspiracy theories in atopic dermatitis.

Misinformation is one of the greatest threats to global health. Atopic dermatitis (AD) is a common skin disorder with a complex multifactorial aetiology, rendering it susceptible to misinformation. Little is known about the content of misinformation regarding AD online. We performed a review of AD-related misinformation available online, via PubMed for scientific papers and Google for nonscientific websites. Key areas of misinformation were identified, including 'simple cures' for AD, diet, chemicals, dust, vaccines, red skin syndrome and alternative therapies. Patients with AD and their families are vulnerable to misinformation given the severe impact of AD on quality of life. Dermatologists must be aware of the false AD-related content being shared online, and be prepared to refute and rebut misinformation by providing appropriate evidence.