Lessons Learned From Interdisciplinary Efforts to Combat COVID-19 Misinformation: Development of Agile Integrative Methods From Behavioral Science, Data Science, and Implementation Science.

Background: Despite increasing awareness about and advances in addressing social media misinformation, the free flow of false COVID-19 information has continued, affecting individuals' preventive behaviors, including masking, testing, and vaccine uptake. Objective: In this paper, we describe our multidisciplinary efforts with a specific focus on methods to (1) gather community needs, (2) develop interventions, and (3) conduct large-scale agile and rapid community assessments to examine and combat COVID-19 misinformation. Methods: We used the Intervention Mapping framework to perform community needs assessment and develop theory-informed interventions. To supplement these rapid and responsive efforts through large-scale online social listening, we developed a novel methodological framework, comprising qualitative inquiry, computational methods, and quantitative network models to analyze publicly available social media data sets to model content-specific misinformation dynamics and guide content tailoring efforts. As part of community needs assessment, we conducted 11 semistructured interviews, 4 listening sessions, and 3 focus groups with community scientists. Further, we used our data repository with 416,927 COVID-19 social media posts to gather information diffusion patterns through digital channels. Results: Our results from community needs assessment revealed the complex intertwining of personal, cultural, and social influences of misinformation on individual behaviors and engagement. Our social media interventions resulted in limited community engagement and indicated the need for consumer advocacy and influencer recruitment. The linking of theoretical constructs underlying health behaviors to COVID-19-related social media interactions through semantic and syntactic features using our computational models has revealed frequent interaction typologies in factual and misleading COVID-19 posts and indicated significant differences in network metrics such as degree. The performance of our deep learning classifiers was reasonable, with an F-measure of 0.80 for speech acts and 0.81 for behavior constructs. Conclusions: Our study highlights the strengths of community-based field studies and emphasizes the utility of large-scale social media data sets in enabling rapid intervention tailoring to adapt grassroots community interventions to thwart misinformation seeding and spread among minority communities. Implications for consumer advocacy, data governance, and industry incentives are discussed for the sustainable role of social media solutions in public health.

Patient and physician satisfaction with telemedicine in pediatric otolaryngology.

OBJECTIVES: 1) Evaluate the caregiver-perceived benefits and barriers of a tertiary pediatric otolaryngology telemedicine service using the validated Telemedicine Satisfaction Questionnaire (TSQ); 2) Explore the provider's perception and experience on the current telemedicine platform using a modified Physician Satisfaction Questionnaire (PSQ). METHODS: Caregivers of patients ≤18 years of age who received telemedicine services from May 4 to June 18, 2020 (duration of telemedicine use) were eligible for this study. Caregivers were contacted via telephone and given the option to answer the TSQ over the phone, receive a link via email, or decline participation. Providers were administered the modified PSQ as an anonymous, self-report online instrument on the 2 nd week of telemedicine implementation. The study authors were excluded from the PSQ. RESULTS: 58/148 caregivers completed the TSQ. The TSQ questions were grouped into three categories: quality of care, similarity to in-person care, and perception of the interaction. Caregivers felt the most satisfied with the perception of the interaction (mean response 4.84, SD 0.08, p < 0.05). With the PSQ, providers had less favorable responses when compared to the TSQ across all categories (p < 0.05 for all categories) but did report satisfaction for the perception of the interaction (mean response 3.37, SD 0.85). CONCLUSION: Our study demonstrates further evidence that the telemedicine may provide positive benefits. Caregivers were supportive of this service due to its convenience. Providers felt confident using this service, but they also felt the care provided was different from that in the clinic. Improvement in the telemedicine platforms and associated technology for physical exams may help improve the quality of telemedicine care, and similarity to in-person care.

The utility of preoperative echocardiography in pediatric obstructive sleep apnea.

PURPOSE: The purpose of this study was to determine the associations between cardiac function and postoperative adverse events in pediatric patients with obstructive sleep apnea (OSA). METHODS: Patients between birth and 18 years of age diagnosed with OSA between January 1, 2015, and December 31, 2018, who underwent echocardiographic evaluation within 6 months of surgery at a tertiary care children's hospital were evaluated. Exclusion criteria included history of neuromuscular disorders, tracheostomy placement, or a predominance of central apneic events recorded during polysomnography (PSG). Patients were grouped by OSA severity. Chi-squared analysis and logistic regression were utilized to determine associations between demographic characteristics, OSA severity, preoperative echocardiographic abnormalities, and postoperative adverse events. RESULTS: One hundred ten children met inclusion criteria for the study, including 22 with mild OSA, 22 with moderate OSA, and 66 with severe OSA. Race and the presence of congenital heart disease (CHD) were significantly associated with differences in OSA severity. Echocardiographic abnormalities were found in 45 patients, but exclusion of patients with CHD revealed no significant associations with differences in OSA severity. Postoperative adverse events were identified in 18 (16%) patients, and only O2 saturation nadir was found to be a significant predictor of these complications. CONCLUSION: Preoperative echocardiogram abnormalities are not commonly found in children with OSA and presence of abnormalities does not predict postoperative adverse events. O2 saturation nadir measured on preoperative PSG is a significant predictor of postoperative adverse events and should be examined as a clinical indicator of OSA severity.