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BackgroundBurnout and the mental health burden of the COVID-19 pandemic have disproportionately impacted health care workers. The links between state policies, federal regulations, COVID-19 case counts, strains on health care systems, and the mental health of health care workers continue to evolve. The language used by state and federal legislators in public-facing venues such as social media is important, as it impacts public opinion and behavior, and it also reflects current policy-leader opinions and planned legislation. ObjectiveThe objective of this study was to examine legislators’ social media content on Twitter and Facebook throughout the COVID-19 pandemic to thematically characterize policy makers’ attitudes and perspectives related to mental health and burnout in the health care workforce. MethodsLegislators’ social media posts about mental health and burnout in the health care workforce were collected from January 2020 to November 2021 using Quorum, a digital database of policy-related documents. The total number of relevant social media posts per state legislator per calendar month was calculated and compared with COVID-19 case volume. Differences between themes expressed in Democratic and Republican posts were estimated using the Pearson chi-square test. Words within social media posts most associated with each political party were determined. Machine-learning was used to evaluate naturally occurring themes in the burnout- and mental health–related social media posts. ResultsA total of 4165 social media posts (1400 tweets and 2765 Facebook posts) were generated by 2047 unique state and federal legislators and 38 government entities. The majority of posts (n=2319, 55.68%) were generated by Democrats, followed by Republicans (n=1600, 40.34%). Among both parties, the volume of burnout-related posts was greatest during the initial COVID-19 surge. However, there was significant variation in the themes expressed by the 2 major political parties. Themes most correlated with Democratic posts were (1) frontline care and burnout, (2) vaccines, (3) COVID-19 outbreaks, and (4) mental health services. Themes most correlated with Republican social media posts were (1) legislation, (2) call for local action, (3) government support, and (4) health care worker testing and mental health. ConclusionsState and federal legislators use social media to share opinions and thoughts on key topics, including burnout and mental health strain among health care workers. Variations in the volume of posts indicated that a focus on burnout and the mental health of the health care workforce existed early in the pandemic but has waned. Significant differences emerged in the content posted by the 2 major US political parties, underscoring how each prioritized different aspects of the crisis.

BackgroundIncorporating insights from social media into the patient-provider encounter is increasingly being explored in health care settings. Less is known about the utility of these data in mental health therapy. ObjectiveThis study aims to prospectively investigate and characterize how social media and digital data are used in mental health therapy from both the patient and mental health therapist perspective. MethodsPatients enrolled in mental health therapy and mental health therapists were interviewed using a semistructured interview guide. All interviews were transcribed and coded using a deductive framework analysis. Themes and subthemes were identified. Participants completed a sociodemographic survey, while mental health therapists also completed a behavioral norms and elicitation survey. ResultsSeventeen participants, that is, 8 (48%) mental health therapists and 9 (52%) patients were interviewed. Overall, participants identified 4 themes and 9 subthemes. Themes were current data collection practices, social media and digital data in therapy, advantages of social media and digital data in therapy, and disadvantages of social media and digital data in therapy. Most subthemes were related to the advantages and disadvantages of incorporating digital data in mental health therapy. Advantage subthemes included convenience, objective, builds rapport, and user-friendliness while disadvantage subthemes were nonreflective, ethically ambiguous, and nongeneralizable. The mental health therapists' behavioral norms and elicitation survey found that injunctive and descriptive normative beliefs mapped onto 2 advantage subthemes: convenience and objectivity. ConclusionsThis qualitative pilot study established the advantages and disadvantages of social media and digital data use in mental health therapy. Patients and therapists highlighted similar concerns and uses. This study indicated that overall, both patients and therapists are interested in and are comfortable to use and discuss social media and digital data in mental health therapy.

BackgroundThe quality of care in labor and delivery is traditionally measured through the Hospital Consumer Assessment of Healthcare Providers and Systems but less is known about the experiences of care reported by patients and caregivers on online sites that are more easily accessed by the public. ObjectiveThe aim of this study was to generate insight into the labor and delivery experience using hospital reviews on Yelp. MethodsWe identified all Yelp reviews of US hospitals posted online from May 2005 to March 2017. We used a machine learning tool, latent Dirichlet allocation, to identify 100 topics or themes within these reviews and used Pearson r to identify statistically significant correlations between topics and high (5-star) and low (1-star) ratings. ResultsA total of 1569 hospitals listed in the American Hospital Association directory had at least one Yelp posting, contributing a total of 41,095 Yelp reviews. Among those hospitals, 919 (59%) had at least one Yelp rating for labor and delivery services (median of 9 reviews), contributing a total of 6523 labor and delivery reviews. Reviews concentrated among 5-star (n=2643, 41%) and 1-star reviews (n=1934, 30%). Themes strongly associated with favorable ratings included the following: top-notch care (r=0.45, P

BackgroundThe COVID-19 pandemic has placed strains on communities. During this public health crisis, health systems have created remote methods of monitoring symptom progression and delivering care virtually. ObjectiveUsing an SMS text message-based system, we sought to build and test a remote model to explore community needs, connect individuals to curated resources, and facilitate community health worker intervention when needed during the pandemic. The primary aims of this pilot study were to establish the feasibility (ie, engagement with the text line) and acceptability (ie, participant ratings of resources and service) of delivering automated well-being resources via smartphone technology. MethodsEligible patients (aged 18 years or older, having a cell phone with SMS text messaging capability, and recently visited the emergency department) were identified using the electronic health record. The patients were consented to enroll and begin receiving COVID-19–related information and links to community resources. We collected open-ended and close-ended resource and mood ratings. We calculated the frequencies and conducted a thematic review of the open-ended responses. ResultsIn 7 weeks, 356 participants were enrolled; 13,917 messages were exchanged including 333 resource ratings (mean 4) and 673 well-being scores (mean 6.8). We received and coded 386 open-ended responses, most of which elaborated upon their self-reported mood score (29%). Overall, 77% (n=274) of our participants rated the platform as a service they would highly recommend to a family member or friend. ConclusionsThis approach is designed to broaden the reach of health systems, tailor to community needs in real time, and connect at-risk individuals with robust community health support.