A video-based analysis of situations bearing the risk of respiratory disease transmission during football matches.

We aimed to analyze the number and type of contacts involving the risk of respiratory disease transmission during football match play. We analysed 50 matches from different playing levels. Two reviewers evaluated the contacts of all players in each match. We focused on between-player contacts, crowding, actions with potentially increased aerosol and droplet production and within-player hand-to-head contacts. We categorized the duels with direct contact into frontal and other ones and measured contact duration. The number of between-player contacts were similar between playing levels (median 28.3 [IQR 22.6, 33] contacts per player-hour). Frontal contacts summed up to 8% of all contacts. Contacts involving the head occurred less than once per player and match with none lasting longer than 3 s. Crowding included between two and six players and the duration was mostly less than 10 s. Aerosol and droplet producing activities were three to four times more frequent in adult compared to youth players. Our results suggest that the risk of respiratory pathogen transmission is low during football matches. This conclusion is based on the finding that most close contact situations are of short duration and on the fact that it is an outdoor sport.

Employing automatic content recognition for teaching methodology analysis in classroom videos.

A teacher plays a pivotal role in grooming a society and paves way for its social and economic developments. Teaching is a dynamic role and demands continuous adaptation. A teacher adopts teaching techniques suitable for a certain discipline and a situation. A thorough, detailed, and impartial observation of a teacher is a desideratum for adaptation of an effective teaching methodology and it is a laborious exercise. An automatic strategy for analyzing a teacher's teaching methodology in a classroom environment is suggested in this work. The proposed strategy recognizes a teacher's actions in videos while he is delivering lectures. In this study, 3D CNN and Conv2DLSTM with time-distributed layers are used for experimentation. A range of actions are recognized for a complete classroom session during experimentation and the reported results are considered effective for analysis of a teacher's teaching technique.

Nursing students' experiences of virtual simulation when using a video conferencing system - a mixed methods study.

OBJECTIVES: There is limited knowledge about students' experiences with virtual simulation when using a video conferencing system. Therefore, the aim of this study was to explore how second-year undergraduate nursing students experienced learning through virtual simulations during the COVID-19 pandemic. METHODS: The study had an exploratory design with both quantitative and qualitative approaches. In total, 69 nursing students participated in two sessions of virtual simulation during spring 2020, and 33 students answered online questionnaires at session 1. To further explore students' experiences, one focus group interview and one individual interview were conducted using a video conferencing system after session 2. In addition, system information on use during both sessions was collected. RESULTS: Changes in the students' ratings of their experiences of virtual simulation with the Body Interact™ system were statistically significant. The virtual simulation helped them to bridge gaps in both the teaching and learning processes. Four important aspects of learning were identified: 1) learning by self-training, 2) learning from the software (Body Interact™), 3) learning from peers, and 4) learning from faculty. CONCLUSIONS: We conclude that virtual simulation through a video conferencing system can be useful for student learning and feedback from both peers and faculty is important.

Satisfaction and Technology Acceptance of Staff Regarding Use of Continuous Video Monitoring in Comparison With Sitters.

OBJECTIVE: The purpose of this study was to determine staff satisfaction and technology acceptance of continuous video monitoring (CVM) in comparison to sitters. BACKGROUND: Traditionally, sitters have been used to prevent falls in hospitals. Continuous video monitoring has emerged to reduce costs associated with sitters while maintaining safety. METHODS: A descriptive online survey using a modified version of the Technology Acceptance Model was used to gain insight on technology acceptance and satisfaction levels of clinical staff related to CVM. RESULTS: Only 12.73% found CVM to be as effective as sitters. Statistical significance was shown comparing sitters with CVM. A positive correlation was found with perceived ease of use and perceived usefulness of CVM. CONCLUSIONS: Understanding staff satisfaction and technology acceptance is imperative for nurse leaders and administration when implementing new technologies.

Comparisons of the Effects of Watching Virtual Reality Videos and Chewing Gum on the Length of Delivery Stages and Maternal Childbirth Satisfaction: A Randomized Controlled Trial.

Background: Maternal childbirth satisfaction is one of the important indicators of the quality of the care provided. The use of non-pharmacological therapies can make the childbirth process a pleasurable event for the mother. This study aimed to compare the effects of watching virtual reality videos and chewing gum on the length of delivery stages and maternal satisfaction. Methods: This clinical trial study was performed on 93 women with first and second pregnancies, who were referred to Allameh Bohlool Hospital in Gonabad and Sajjadieh Hospital in Torbat-e-Jam, Iran, for childbirth between 2018 and 2019. Pregnant women were randomly assigned to three groups of chewing gum, virtual reality, and control. Interventions were performed twice: in the active (dilation of 4-5 cm) and second (dilation of 7-8 cm) phases of parturition for 20 minutes each. Data were collected using data-gathering forms, including a demographic characteristics form, a midwifery characteristics form, and the Mackey Childbirth Satisfaction Rating Scale. The data were analyzed using SPSS, version 22, via the Chi square tests, ANOVA, Kruskal-Wallis, and Tukey's post hoc tests. Results: The difference in the mean maternal childbirth satisfaction score between the two intervention groups of virtual reality and chewing gum was not statistically significant (P=0.339), but the mean score in the intervention groups was higher than that of the control group (P<0.001(. There was no significant difference in the mean length of the active and second phases of parturition between the two intervention groups, but this value in the intervention groups was significantly lower than that of the control group. Conclusion: The thought divergence interventions of chewing gum and watching virtual reality videos enhanced childbirth satisfaction, and curtailed parturition stages in our sample of pregnant women. Trial Registration Number: IRCT20181214041963N1.

A scoping review of PhotoVoice for people with post-stroke aphasia.

BACKGROUND: PhotoVoice is a qualitative research methodology designed to engage and empower marginalized members of a community and/or to understand community needs. PhotoVoice seems aphasia-friendly because it relies on personal photographs to convey opinions regarding prespecified topics. However, PhotoVoice is based on a procedure referred to as the SHOWeD method. Participants are asked to reflect upon their photos by discussing (1) what they See, (2) what is Happening, (3) the relation to Our life, (3) Why the issue or condition exists, and then to (4) explain what can be Done to address the issue(s) at hand. Due to the linguistic demand required to convey complex thoughts and ideas inherent in this methodology, adaptations are likely required to successfully implement with people who have aphasia. AIMS: A scoping review was conducted to summarize the current literature regarding the use of PhotoVoice with people who have aphasia, to address two questions:(1) Are people with post-stroke aphasia included in PhotoVoice studies?(2) What, if any, modifications are required to address post-stroke aphasia and motor impairments? MAIN CONTRIBUTION: This scoping review revealed that researchers often exclude people with aphasia from post-stroke PhotoVoice research. Three studies outlined adaptations that allowed successful implementation with people who have post-stroke aphasia. CONCLUSIONS: Further inquiry regarding how best to adapt PhotoVoice for people with aphasia will facilitate their ability to be included in community-based research. This is an important step in ensuring that all post-stroke stakeholders are involved in projects related to social justice and policy for stroke survivors.

#ItsNotInYourHead: A Social Media Campaign to Disseminate Information on Provoked Vestibulodynia.

Provoked Vestibulodynia (PVD) is a type of localized vulvodynia (or pain in the vulva). The estimated prevalence of this condition is about 12% of the general population and approximately 20% of women under the age of 19. Many women who live with PVD suffer in silence for years before receiving a diagnosis. Whereas cognitive behavioral therapy (CBT) was already known to be effective for managing symptoms of PVD, there has recently been a published head-to-head comparison of CBT versus mindfulness-based therapy for the primary outcome of pain intensity with penetration. The trial revealed that both treatments were effective and led to statistically and clinically meaningful improvements in sexual function, quality of life, and reduced genital pain, with improvements retained at both 6- and 12-month follow-ups. We then undertook an end-of-grant knowledge translation (KT) campaign focused on the use of social media to disseminate an infographic video depicting the findings. Social media was strategically chosen as the primary mode of dissemination for the video as it has broad reach of audience, the public can access information on social media for free, and it presented an opportunity to provide social support to the population of women with PVD who are characterized as suffering in silence by starting a sensitive and empowering dialogue on a public platform. In this paper, we summarize the social media reach of our campaign, describe how and why we partnered with social media influencers, and share lessons learned that might steer future KT efforts in this field.

#postbabyhankypanky: An Empirically Based Knowledge Sharing Initiative About Sex and the Transition to Parenthood.

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark further interest and communication for both new parents and healthcare providers. We convened a multidisciplinary advisory group that also involved community parents who provided feedback at all phases of this project. We developed five brief YouTube videos, each featuring a core research finding. Following an empirically supported strategic knowledge translation plan, we disseminated the videos to our target audiences (i.e., expectant and new parents, healthcare providers, educators, and other stakeholders) using social media from February 2018 to November 2019. Data were collected using YouTube analytics and an online survey (convenience sample: N = 225 parents; N = 161 healthcare providers). From the date of the launch, the videos had a reach of 91,766 views from 14 countries, with viewers watching an average of 90% of a video. Overall, quantitative and qualitative survey results suggested that the videos were acceptable and appropriate, and respondents were more confident and comfortable discussing sexual issues (with their partner/with their patients) and would like more information about postpartum sexuality after watching the videos. YouTube videos are an acceptable and effective way to disseminate evidence aimed at raising awareness of factors affecting sexuality in the transition to parenthood.

Translating Knowledge of Sexual Configurations Theory via Instructional Videos.

Gender/sex and sexual diversity are increasingly understood by the public as complex. But, scientific frameworks that address the complexity of gender/sex and sexual diversity are few and not well situated for the public. Sexual configurations theory (SCT; van Anders, 2015) is one approach that provides a visual framework for understanding and measuring gender/sex and sexual diversity. But how might knowledge users and creators actually use it? To make SCT more accessible to researchers, educators, clinicians, and the general public, we created three instructional videos (individual gender/sex, gender/sex sexuality, and partner number sexuality) that explained SCT and demonstrated how to use its diagrams. Participants (N = 242) of diverse gender/sex and sexual identities, including professionals who work in gender/sex- and sexuality-related fields, watched one of the three videos, filled out the diagrams, and evaluated the video and diagrams via scaled and open-ended questions. Results demonstrated that the SCT videos were sufficient for most participants to fill out the diagrams. Participants evaluated the video generally positively, with some variation by condition, identity group, and professional status. These results indicate that instructional videos are able to translate SCT, potentially facilitating uptake of SCT by clinicians, researchers, and educators as well as increasing awareness of gender/sex and sexual diversity more broadly within the public.

Increased Female Athlete Triad Knowledge Among Collegiate Dancers Following a Brief Educational Video Intervention.

The female athlete triad (triad) is prevalent among aesthetic athletes, including dancers. However, there is limited research regarding triad knowledge or triad educational interventions among collegiate dancers. This study was intended to help correct that shortage. Participants (N = 24) completed two questionnaires: one assessed demographics, triad risk, and disordered eating (DE) risk; the other measured triad knowledge before and after viewing a 10-minute triad video. Twenty-seven percent of participants were found to be at risk for DE, 27% were at risk for the triad, and 8% were at risk for both. Significant improvements in triad knowledge were observed following the educational video; 4.08 ± 1.83 pre-intervention to 6.75 ± 0.09 post-intervention out of a possible 7, p < 0.001. There were no differences in triad knowledge when comparing freshmen and sophomores to juniors, seniors, and graduate students. This research confirms that triad education should be a continuous component of collegiate dancers' curricula to promote their overall health and wellness, and that the triad video can be an effective educational tool for supporting that goal.

Pilot Study of Videos to Deliver Mindfulness-Based Art Therapy for Adults With Multiple Sclerosis.

BACKGROUND: Mindfulness-based art therapy (MBAT) has been shown to provide a strategy for adults with multiple sclerosis (MS) to self-manage their symptoms. There is a need for the use of an MBAT intervention that can be delivered in any setting for adults with MS. The purpose of this pilot feasibility study was to test the feasibility and acceptability of an MBAT intervention delivered via videoconference. METHODS: We developed an MBAT intervention to be delivered by videoconference to adults with MS recruited from an academic center registry. We also conducted phone interviews to collect acceptability data. RESULTS: Most of the participants (n = 5) were very positive about the MBAT video sessions and stated content as clear and easy to follow and understand. The time and delivering method were acceptable. CONCLUSION: Mindfulness-based art therapy sessions delivered through videoconference are acceptable and feasible for adults with MS.

In-Home Diagnosis of Obstructive Sleep Apnea Using Automatic Video Analysis / Diagnóstico domiciliario de apnea obstructiva del sueño utilizando el análisis automático de vídeo

Study objectives: To evaluate the diagnostic accuracy of a non-invasive technology based on image processing for the identification of obstructive sleep apnea (OSA) and its severity at patients' home. METHODS: Observational, prospective, diagnostic accuracy study to evaluate the degree of measure agreement between Sleepwise (SW), in-laboratory attended polysomnography (PSG) and a home sleep apnea test (HSAT). 38 consecutive subjects with suspected OSA referred as outpatients to the sleep unit were recruited from September 2016 to September 2017. All patients underwent in-laboratory attended PSG and image processing with SW simultaneously overnight. Subsequently, a HSAT and image processing with SW were performed simultaneously overnight at patients' home, and the 2 nights after, patients underwent only image processing with SW consecutively. RESULTS: In-laboratory polysomnography and SW had a Lin's concordance correlation coefficient of 0.933 and a Kappa of 0.930. Between HSAT and SW the Lin's concordance correlation coefficient was 0.842 and a Kappa of 0.571. Agreement between two consecutive nights with SW recording showed a Lin's concordance correlation coefficient of 0.923 and a Kappa of 0. 837. CONCLUSIONS: SW was highly accurate for non-invasive and automatic diagnosis of OSA in outpatients compared to standard methods for OSA diagnosis either in-laboratory attended PSG or HSAT. SW proved to be a technique with repeatable and concordant results on different nights for the same patient. We conclude SW is a non-invasive, easy-to-use, portable, effective and highly accurate system for the in-home diagnosis of OSA

OBJETIVOS: Evaluar la precisión diagnóstica de una tecnología no invasiva basada en el procesamiento de imágenes para la identificación de la apnea obstructiva del sueño (AOS) y su gravedad en el domicilio de los pacientes. MÉTODOS: Estudio observacional, prospectivo y de precisión diagnóstica para evaluar el grado de concordancia entre las mediciones de Sleepwise (SW), polisomnografía (PSG) asistida en el laboratorio y poligrafía respiratoria domiciliaria (PRD). Se reclutaron 38 sujetos consecutivos con sospecha de AOS, referidos como pacientes ambulatorios a la unidad de sueño entre septiembre de 2016 y septiembre de 2017. Se les realizó a todos una PSG y procesamiento de imagen con SW durante la noche en el laboratorio. Posteriormente, se realizó una PRD y procesamiento de imágenes con SW de forma simultánea durante la noche en su domicilio, y las 2 noches siguientes los pacientes se sometieron solo a procesamiento de imágenes con SW. RESULTADOS: La polisomnografía en el laboratorio y el SW mostraron un coeficiente de correlación de concordancia de Lin de 0,933 y un Kappa de 0,930. Entre la PRD y el SW el coeficiente de correlación de concordancia de Lin fue de 0,842 y un Kappa de 0,571. La concordancia entre las 2 noches consecutivas de grabación con el SW mostró un coeficiente de correlación de concordancia de Lin de 0,923 y un Kappa de 0,837. CONCLUSIONES: El SW mostró alta precisión para el diagnóstico no invasivo y automatizado de la AOS en pacientes ambulatorios en comparación con los métodos estándar para el diagnóstico de la AOS, ya sean la PSG asistida en el laboratorio o la PRD. El SW demostró ser una técnica con resultados reproducibles y concordantes en diferentes noches para el mismo paciente. Concluimos que la SW es un sistema no invasivo, fácil de usar, portátil, eficaz y altamente preciso para el diagnóstico domiciliario de la AOS

Toward a human-centered use of technology: a stakeholder analysis of harm reduction and CBO staff.

BACKGROUND: Technology can enable syringe service programs (SSPs) and other community-based organizations (CBOs) operating under a harm reduction framework to work with an increased number of clients and can also enable organizations to offer services more effectively (e.g., offering HIV testing in ways participants may be more likely to accept). In the current time of COVID-19 social distancing, technology can also help organizations more safely provide services to people with compromised immune systems and to clients who might otherwise not be reached. However, technology projects implemented in harm reduction settings are frequently conceptualized and developed by researchers or technology specialists rather than by SSP staff or clients. METHODS: To more effectively meet the needs of SSPs and other CBOs across the USA, our team conducted qualitative interviews with 16 individuals who have extensive backgrounds working in the field of harm reduction. Interviews were digitally recorded and professionally transcribed, and the transcripts were checked for accuracy by the interviewers. The resulting transcripts were coded and analyzed to determine emerging themes. RESULTS: Interviewees mentioned the ability of technology to deliver consistent quality messaging to multiple clients at the same time and the potential to customize or tailor technology-based messaging to specific client populations as positive benefits. Clear barriers to technology use also emerged, in particular regarding privacy, data security, and the need to maintain client trust when discussing sensitive issues (e.g., illicit drug use). CONCLUSIONS: Technology offers the potential to deliver consistently high-quality health communication and maintain contact with clients who may have no other access to care. If designed and managed effectively, technology can also address issues related to providing services during times when physical contact is limited due to COVID-19 social distancing measures.

Evaluation of a Cognitive-Behavioral Game Design-Based Mobile Game on Alcohol Use for Adolescents.

Objective: Determine the effectiveness of a cognitive behavioral game design (CBGD) based mobile game as an alcohol use intervention. Materials and Methods: Experimental design with 140 participants randomly assigned to either play a mobile game (n = 69) or watch a video documentary (n = 71). Results: Both groups displayed a decrease in intent to use and an increase in knowledge. The video intervention was superior in affecting actual use. Conclusion: Mobile game affects intent to use and is superior to the video in affecting knowledge.

Development of an instructional movie illustrating a standardized clinical examination on patients with TMD symptoms.

Objectives: The aim of this project was to develop an instructional video that demonstrates a standardized clinical examination on patients with suspected temporomandibular disorders (TMD). After viewing the video, the learner should be knowledgeable about the examination steps and application of the examination techniques. Methods: The instructional video was created by two dentists who are experienced in assessing patients with suspected TMD. Additionally, both examiners were calibrated according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The instructional video was divided into chapters. Various camera angles, key points, image enlargements, and replays were used to better depict essential aspects of the assessment. Background noise was reduced to a minimum. Results: The instructional video was modified and completed in two phases: the first by an experienced dentist and the second by a dentist specialized in TMD. The final video includes nine chapters and is 26.5 minutes in length (https://doi.org/10.5061/dryad.k8r7qc1). Conclusion: Divided into chapters, this German instructional video shows an optimally timed, standardized clinical assessment of patients with suspected TMD.

Evaluation of the reliability, utility, and quality of the information in cardiopulmonary resuscitation videos shared on Open access video sharing platform YouTube.

BACKGROUND: The internet is a widely used source for obtaining medical information both by patients and physicians. YouTube is an essential source of information that may be a useful tool to inform the public and may improve the learning experience if used adequately. In this study, we aimed to estimate the quality and accuracy of videos about cardiopulmonary resuscitation videos aired on YouTube, which is the most popular video platform of the online world. METHODS: We included the first 100 videos, in English, returned by the YouTube search engine in response to "cardiopulmonary resuscitation" keyword query to the study. The popularity of the videos was evaluated with an index called the video power index. The educational quality, accuracy, and transparency of the visual content were measured using the DISCERN questionnaire (DISCERN), Journal of American Medical Association (JAMA-BC) benchmark criteria, and Global Quality Score (GQS). The technical quality was measured by the Cardiopulmonary Resuscitation Scoring System (CPR-SS), which was utilized by three bariatric surgeons. RESULTS: The source in 7% of the videos was medical doctors. The content in 89% of the videos was cardiopulmonary resuscitation technique. According to sources, videos uploaded by physicians had significantly higher quality, transparency, educational and technical value. Unlike, videos uploaded by physicians had a lower video power index than videos uploaded by non-medical professionals. Cardiopulmonary resuscitation technique videos had significantly higher quality, transparency, educational and technical value. Cardiopulmonary resuscitation technique videos also had higher popularity scores than "information or lecture" videos. Also, negative correlations were found between the (popularity index and transparency, education and technical quality scores. CONCLUSIONS: Online information on cardiopulmonary resuscitation is of low quality, and its contents are of unknown source and accuracy. However, the educational potential of the online video platform, YouTube, cannot be neglected.

The Impact of Video-Mediated Communication on Closed Wound Assessments in Postoperative Consultations: Conversation Analytical Study.

BACKGROUND: Research on the use of video-mediated technology for medical consultations is increasing rapidly. Most research in this area is based on questionnaires and focuses on long-term conditions. The few studies that have focused on physical examinations in video consultations indicated that it poses challenges for the participants. The specific activity of wound assessment through video in postsurgery consultations has not yet been studied. Furthermore, a comparative analysis of face-to-face and video settings on the moment-to-moment organization of such an activity is original. OBJECTIVE: The aim of this study was to examine the impact of video technology on the procedure of postsurgery wound assessment and its limits. METHODS: We recorded 22 postoperative video consultations and 17 postoperative face-to-face consultations. The primary purpose of the consultation was to inform the patient about the final pathology results of the resected specimen, and the secondary purpose was to check on the patient's recovery, including an assessment of the closed wound. The recordings were transcribed in detail and analyzed using methods of conversation analysis. RESULTS: The way that an assessment of the wound is established in video consultations differs from the procedure in face-to-face consultations. In the consultation room, wound assessments overwhelmingly (n=15/17) involve wound showings in the context of surgeons reporting their observations formatted with evidentials ("looks neat") and subsequently assessing what these observations imply or what could be concluded from them. In contrast, wound assessments in video consultations do not tend to involve showing the wound (n=3/22) and, given the technological restrictions, do not involve palpation. Rather, the surgeon invites the patient to assess the wound, which opens up a sequence of patient and physician assessments where diagnostic criteria such as redness or swollenness are made explicit. In contrast to observations in regular consultations, these assessments are characterized by epistemic markers of uncertainty ("I think," "sounds...good") and evidentials are absent. Even in cases of a potential wound problem, the surgeon may rely on questioning the patient rather than requesting a showing. CONCLUSIONS: The impact of video technology on postoperative consultations is that a conclusive wound assessment is arrived at in a different way when compared to face-to-face consultations. In video consultations, physicians enquire and patients provide their own observations, which serve as the basis for the assessment. This means that, in video consultations, patients have a fundamentally different role. These talking-based assessments are effective unless, in cases of a potential problem, patient answers seem insufficient and a showing might be beneficial.

Fiction, Falsehoods, and Few Facts: Cross-Sectional Study on the Content-Related Quality of Atopic Eczema-Related Videos on YouTube.

BACKGROUND: In recent years, YouTube has become a recognized source of medical information for health care consumers. Although YouTube has advantages in this context, there are potential dangers as videos may contain nonscientific, misleading, or even harmful information. OBJECTIVE: As little is known about YouTube as a source of information on atopic dermatitis (AD), we investigated the content-related quality of AD videos and their perception among YouTube users. METHODS: The quality of the 100 most viewed AD videos was assessed by using the Global Quality Scale (GQS) and the DISCERN instrument. Videos were classified as "useful," "misleading," and "potentially harmful," and the correlations of viewers' ratings (likes) with the GQS and DISCERN scores were assessed. RESULTS: Among the 100 videos, 68.0% (68/100) and 62.0% (62/100) were of poor and very poor scientific quality, respectively. Additionally, 32.0% (32/100) of the videos were classified as useful, 48.0% (48/100) were classified as misleading, and 34.0% (34/100) were classified as potentially harmful. Viewers' ratings did not correlate with the GQS and DISCERN scores. Overall, 50.0% (50/100) of the videos were posted by private individuals and promoters of complementary/alternative treatments, 42.0% (42/100) by therapeutical advertisers, and only 8.0% (8/100) by nonprofit organizations/universities. CONCLUSIONS: Our study demonstrated that two-thirds of the videos analyzed were below acceptable medical quality standards and that many videos were disseminating misleading or even dangerous content. Subjective and anecdotal content was overrepresented, and viewers did not appear to be able to distinguish between high- and low-quality videos. Health promotion strategies by professional medical organizations are needed to improve their presence and visibility on YouTube.

The Buffering Effect of Health Care Provider Video Biographies When Viewed in Combination With Negative Reviews: "You Can't Fake Nice".

BACKGROUND: Patients seek information from numerous sources before choosing a primary care provider; two of the most popular sources are providers' own online biographies and patient rating websites. However, prior research has generally only examined how these sources influence patients' decisions in isolation. OBJECTIVE: This study aimed to determine how primary care providers' online biographies and online patient ratings interact to affect patients' decision making, especially in the face of negative reviews. METHODS: An 8-condition online experiment (n=866) was conducted, manipulating patient ratings and the timing of viewing a provider's online biographical video (pre- or postrating viewing). RESULTS: When participants were shown a short video introduction of a provider after reading predominantly negative reviews a positive expectancy violation occurred, which was also related to more positive perceptions of the provider. When exposed to all negative reviews, 43% of participants indicated they would still choose to make an appointment with the provider, with many indicating that the video provided the evidence needed to help make up their own minds. CONCLUSIONS: These findings are especially relevant to health care organizations seeking to combat a recent rise in fake patient reviews. Providing patients with realistic expectations of the care that clinicians can offer via their own online biographical videos can help counteract negative patient comments online.