Search

ABSTRACTThis study examined 100 widely viewed YouTube videos on COVID-19 vaccination. Information such as length, format, upload source, content, and cumulative views was coded. As of April 6, 2020, the videos were viewed >33 million times. Almost 75% were uploaded by news sources (garnering >20 million views). While only 16% were uploaded by consumers, these videos garnered over 25% of cumulative views (n = 8,581,186 views). The majority of videos mentioned the vaccine manufacturing process (61.0%) and 45.0% speculated on the amount of time needed to have a vaccine ready for use, which most often was thought to be 1–2 years. Even once the biological and technical aspects of vaccine development and manufacturing are accomplished, the benefits conferred on population health will also depend on public willingness to be vaccinated. Ongoing tracking of YouTube is needed to identify what is communicated about vaccines for COVID-19. To the extent that public health officials learn how to create videos about the safety and effectiveness of a COVID-19 vaccine, which attract viewers, this could help increase awareness and interest about vaccination and help individuals make an informed decision about vaccine uptake.

Given that individuals may make health decisions based on mass media coverage, and given that such decisions have broad consequences in the case of highly contagious infectious disease, it is imperative that public health practitioners are aware of mass media coverage on emerging health threats such as COVID-19. The purpose of this study was to examine the content of news segments covering COVID-19 posted on-line.

ABSTRACTObjective:The purpose of this study was to assess the readability of information on the Internet posted about coronavirus disease 2019 (COVID-19) to determine how closely these materials are written to the recommended reading levels.Methods:Using the search term “coronavirus,” information posted on the first 100 English language websites was identified. Using an online readability calculator, multiple readability tests were conducted to ensure a comprehensive representation would result.Results:The mean readability scores ranged between grade levels 6.2 and 17.8 (graduate school level). Four of the 5 measures (GFI, CLI, SMOG, FRE) found that readability exceeded the 10th grade reading level indicating that the text of these websites would be difficult for the average American to read. The mean reading level for nearly all noncommercial and commercial websites was at or above the 10th grade reading level.Conclusions:Messages about COVID-19 must be readable at an “easy” level, and must contain clear guidelines for behavior. The degree to which individuals seek information in response to risk messages is positively related to the expectation that the information will resolve uncertainty. However, if the information is too complex to interpret and it fails to lead to disambiguation, this can contribute to feelings of panic.

IMPORTANCE: Not all women initiate clinically indicated breast cancer adjuvant treatment. It is important for clinicians to identify women at risk for noninitiation. OBJECTIVE: To determine whether complementary and alternative medicine (CAM) use is associated with decreased breast cancer chemotherapy initiation. DESIGN, SETTING, AND PARTICIPANTS: In this multisite prospective cohort study (the Breast Cancer Quality of Care [BQUAL] study) designed to examine predictors of breast cancer treatment initiation and adherence, 685 women younger than 70 years with nonmetastatic invasive breast cancer were recruited from Columbia University Medical Center, Kaiser Permanente Northern California, and Henry Ford Health System and enrolled between May 2006 and July 31, 2010. Overall, 306 patients (45%) were clinically indicated to receive chemotherapy per National Comprehensive Cancer Network guidelines. Participants were followed for up to 12 months. EXPOSURES: Baseline interviews assessed current use of 5 CAM modalities (vitamins and/or minerals, herbs and/or botanicals, other natural products, mind-body self-practice, mind-body practitioner-based practice). CAM use definitions included any use, dietary supplement use, mind-body use, and a CAM index summing the 5 modalities. MAIN OUTCOMES AND MEASURES: Chemotherapy initiation was assessed via self-report up to 12 months after baseline. Multivariable logistic regression models examined a priori hypotheses testing whether CAM use was associated with chemotherapy initiation, adjusting for demographic and clinical covariates, and delineating groups by age and chemotherapy indication. RESULTS: A cohort of 685 women younger than 70 years (mean age, 59 years; median age, 59 years) with nonmetastatic invasive breast cancer were recruited and followed for up to 12 months to examine predictors of breast cancer treatment initiation. Baseline CAM use was reported by 598 women (87%). Chemotherapy was initiated by 272 women (89%) for whom chemotherapy was indicated, compared with 135 women (36%) for whom chemotherapy was discretionary. Among women for whom chemotherapy was indicated, dietary supplement users and women with high CAM index scores were less likely than nonusers to initiate chemotherapy (odds ratio [OR], 0.16; 95% CI, 0.03-0.51; and OR per unit, 0.64; 95% CI, 0.46-0.87, respectively). Use of mind-body practices was not related to chemotherapy initiation (OR, 1.45; 95% CI, 0.57-3.59). There was no association between CAM use and chemotherapy initiation among women for whom chemotherapy was discretionary. CONCLUSIONS AND RELEVANCE: CAM use was high among patients with early-stage breast cancer enrolled in a multisite prospective cohort study. Current dietary supplement use and higher number of CAM modalities used but not mind-body practices were associated with decreased initiation of clinically indicated chemotherapy. Oncologists should consider discussing CAM with their patients during the chemotherapy decision-making process.

Participation in clinical trials is essential to bringing novel and innovative cancer treatments to the bedside but trials that specifically enroll Veterans are relatively few. Given the inherent differences between Veterans and the general U.S. population, we sought to investigate awareness of and attitudes toward clinical trials among Veterans diagnosed with cancer at a large, urban Veterans Administration Medical Center in Bronx, New York.

Clinical trials are critically important for the development of new cancer treatments. According to recent estimates, however, clinical trial enrollment is only about 8%. Lack of patient understanding or awareness of clinical trials is one reason for the low rate of participation. The purpose of this observational study was to evaluate the readability of cancer clinical trial websites designed to educate the general public and patients about clinical trials. Nearly 90% of Americans use Google to search for health-related information. We conducted a Google Chrome Incognito search in 2018 using the keywords “cancer clinical trial” and “cancer clinical trials.” Content of the 100 cancer clinical trial websites was analyzed using an online readability panel consisting of Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook scales. Reading level difficulty was assessed and compared between commercial versus non-commercial URL extensions. Content readability was found to be “difficult” (10.7 grade level). No significant difference in readability, overall, and between commercial and non-commercial URL extensions was found using 4/5 measures of readability; 90.9% of commercial versus 49.4% of non-commercial websites were written at a >10th grade (P= .013) using Gunning-Fog Index. Written cancer clinical trials content on the Internet is written at a reading level beyond the literacy capabilities of the average American reader. Improving readability to accommodate readers with basic literacy skills will provide an opportunity for greater comprehension that could potentially result in higher rates of clinical trial enrollment.

Given the popularity and reach of Instagram among American adolescents and young adults (AYA), the well-known influence of social media on the behaviors of youth, and the rising rates of melanoma in this age group, this study sought to examine and describe the content of a sample of Instagram posts related to skin cancer. At three different times, a search of Instagram was conducted using #skincancer as the hashtag. Descriptive analyses of Instagram characteristics and content was performed. Overall, content focused on prevention (33.3%), skin cancer treatment (29.3%) and preventive measures such as using sunscreen and protective gear (29.3%). Nearly one-quarter discussed the ABCDEs (Asymmetrical; Borders are irregular; Color is not even; Diameter is large; Evolving) of screening and detection. Instagram postings that covered skin cancer prevention (n = 50, 33.3%) more often discussed the role of sun exposure in the development of skin cancer (28.0% vs. 10.0%, p = 0.005) and use of sunscreen and protective gear (62.0% vs. 13.0%, p < 0.001). The findings of this study indicate that a considerable portion of the Instagram posts included in this study focused on prevention. Thus, indicating that Instagram could be used to promote health, particularly among AYA.

YouTube™ is a frequently visited website that contains a large and diverse collection of health-related videos. The aim of this study was to identify the most popular videos on YouTube™.com related to human papillomavirus (HPV) and describe their content. This cross-sectional study involved using the search terms “HPV” and “human papillomavirus” to determine a purposive sample composed of an equal number of the most popular “professional” (n=35) and “consumer” (n=35) videos identified. Video content was analyzed and those videos related to HPV vaccination in any way were analyzed further to denote the nature of the message. The majority of videos (81.4%) provided general information related to HPV, discussed the association of HPV infection and the development of cancer (81.4%), and addressed HPV screening (64.3%). Just under one-half (n=34) of the videos addressed vaccination. Fifteen of these were neutral, while six were encouraging and 13 were discouraging. The videos included in this study were viewed ~17 million times, which indicates their potential for influencing public awareness and opinions. Of the videos devoted to HPV vaccination, few were encouraging. These videos may impede efforts to increase rates of HPV vaccination, which are already far below target levels.