TY - JOUR AU - Zippi, D. Zachary AU - Cortopassi, O. Isabel AU - Grage, A. Rolf AU - Johnson, M. Elizabeth AU - McCann, R. Matthew AU - Mergo, J. Patricia AU - Sonavane, K. Sushil AU - Stowell, T. Justin AU - Little, P. Brent PY - 2025/3/11 TI - Assessing Public Interest in Mammography, Computed Tomography Lung Cancer Screening, and Computed Tomography Colonography Screening Examinations Using Internet Search Data: Cross-Sectional Study JO - JMIR Cancer SP - e53328 VL - 11 KW - lung cancer KW - lung cancer screening KW - breast cancer KW - mammography KW - colon cancer KW - CT colonography KW - Google search KW - internet KW - Google Trends KW - imaging-based KW - cancer screening KW - search data KW - noninvasive KW - cancer KW - CT KW - online KW - public awareness KW - big data KW - analytics KW - patient education KW - screening uptake N2 - Background: The noninvasive imaging examinations of mammography (MG), low-dose computed tomography (CT) for lung cancer screening (LCS), and CT colonography (CTC) play important roles in screening for the most common cancer types. Internet search data can be used to gauge public interest in screening techniques, assess common screening-related questions and concerns, and formulate public awareness strategies. Objective: This study aims to compare historical Google search volumes for MG, LCS, and CTC and to determine the most common search topics. Methods: Google Trends data were used to quantify relative Google search frequencies for these imaging screening modalities over the last 2 decades. A commercial search engine tracking product (keywordtool.io) was used to assess the content of related Google queries over the year from May 1, 2022, to April 30, 2023, and 2 authors used an iterative process to agree upon a list of thematic categories for these queries. Queries with at least 10 monthly instances were independently assigned to the most appropriate category by the 2 authors, with disagreements resolved by consensus. Results: The mean 20-year relative search volume for MG was approximately 10-fold higher than for LCS and 25-fold higher than for CTC. Search volumes for LCS have trended upward since 2011. The most common topics of MG-related searches included nearby screening locations (60,850/253,810, 24%) and inquiries about procedural discomfort (28,970/253,810, 11%). Most common LCS-related searches included CT-specific inquiries (5380/11,150, 48%) or general inquiries (1790/11,150, 16%), use of artificial intelligence or deep learning (1210/11,150, 11%), and eligibility criteria (1020/11,150, 9%). For CTC, the most common searches were CT-specific inquiries (1800/5590, 32%) or procedural details (1380/5590, 25%). Conclusions: Over the past 2 decades, Google search volumes have been significantly higher for MG than for either LCS or CTC, although search volumes for LCS have trended upward since 2011. Knowledge of public interest and queries related to imaging-based screening techniques may help guide public awareness efforts. UR - https://cancer.jmir.org/2025/1/e53328 UR - http://dx.doi.org/10.2196/53328 ID - info:doi/10.2196/53328 ER - TY - JOUR AU - Sommers, Jonathan AU - Dizon, S. Don AU - Lewis, A. Mark AU - Stone, Erik AU - Andreoli, Richard AU - Henderson, Vida PY - 2025/3/3 TI - Assessing Health Information Seeking Behaviors Among Targeted Social Media Users Using an Infotainment Video About a Cancer Clinical Trial: Population-Based Descriptive Study JO - JMIR Cancer SP - e56098 VL - 11 KW - cancer clinical trials KW - digital media KW - social media KW - infotainment KW - recruitment KW - education and awareness KW - edutainment KW - public engagement KW - cancer KW - lack of information KW - health information KW - medical awareness KW - video series KW - public audience KW - low cost KW - research participants N2 - Background: The lack of information and awareness about clinical trials, as well as misconceptions about them, are major barriers to cancer clinical trial participation. Digital and social media are dominant sources of health information and offer optimal opportunities to improve public medical awareness and education by providing accurate and trustworthy health information from reliable sources. Infotainment, material intended to both entertain and inform, is an effective strategy for engaging and educating audiences that can be easily disseminated using social media and may be a novel way to improve awareness of and recruitment in clinical trials. Objective: The purpose of this study was to evaluate whether an infotainment video promoting a clinical trial, disseminated using social media, could drive health information seeking behaviors. Methods: As part of a video series, we created an infotainment video focused on the promotion of a specific cancer clinical trial. We instituted a dissemination and marketing process on Facebook to measure video engagement and health information seeking behaviors among targeted audiences who expressed interest in breast cancer research and organizations. To evaluate video engagement, we measured reach, retention, outbound clicks, and outbound click-through rate. Frequencies and descriptive statistics were used to summarize each measure. Results: The video substantially increased health information seeking behavior by increasing viewership from 1 visitor one month prior to launch to 414 outbound clicks from the video to the clinical trial web page during the 21-day social media campaign period. Conclusions: Our study shows that digital and social media tools can be tailored for specific target audiences, are scalable, and can be disseminated at low cost, making it an accessible educational, recruitment, and retention strategy focused on improving the awareness of clinical trials. Trial Registration: ClinicalTrials.gov NCT03418961; https://clinicaltrials.gov/study/NCT03418961 UR - https://cancer.jmir.org/2025/1/e56098 UR - http://dx.doi.org/10.2196/56098 ID - info:doi/10.2196/56098 ER - TY - JOUR AU - Yang, Hongwu AU - Zhu, Chuangying AU - Zhou, Chunyan AU - Huang, Ruibin AU - Huang, Lipeng AU - Chen, Peifen AU - Zhu, Shanshan AU - Wang, Huanpeng AU - Zhu, Chunmin PY - 2025/2/19 TI - Evaluation of Douyin Short Videos on Mammography in China: Quality and Reliability Analysis JO - JMIR Cancer SP - e59483 VL - 11 KW - breast cancer KW - mammography KW - Douyin KW - information quality KW - social media KW - video KW - DISCERN KW - Global Quality Score KW - web-based education KW - cancer screening KW - health information KW - medical content N2 - Background: Breast cancer is the most common malignant tumor and the fifth leading cause of cancer death worldwide, imposing a significant disease burden in China. Mammography is a key method for breast cancer screening, particularly for early diagnosis. Douyin, a popular social media platform, is increasingly used for sharing health information, but the quality and reliability of mammography-related videos remain unexamined. Objective: This study aimed to evaluate the information quality and reliability of mammography videos on Douyin. Methods: In October 2023, a search using the Chinese keywords for ?mammography? and ?mammography screening? was conducted on Douyin. From 200 retrieved videos, 136 mammography-related videos were selected for analysis. Basic video information, content, and sources were extracted. Video content was assessed for comprehensiveness across 7 categories: conception, examination process, applicable objects, precautions, combined examinations, advantages, and report. Completeness was evaluated using a researcher-developed checklist, while reliability and quality were measured using 2 modified DISCERN (mDISCERN) tool and the Global Quality Score (GQS). Correlations between video quality and characteristics were also examined. Results: Among the video sources, 82.4% (112/136) were attributed to health professionals, and 17.6% (24/136) were attributed to nonprofessionals. Among health professionals, only 1 was a radiologist. Overall, 77.2% (105/136) of the videos had useful information about mammography. Among the useful videos, the advantages of mammography were the most frequently covered topic (53/105, 50.5%). Median values for the mDISCERN and GQS evaluations across all videos stood at 2.5 (IQR 1.63?3) and 2 (IQR 1?2), respectively. Within the subgroup assessment, the median mDISCERN score among the useful and professional groups stood at 2 (IQR 2?3) and 3 (IQR 2?3), respectively, surpassing the corresponding score for the unhelpful and nonprofessional groups at 0 (IQR 0?0) and 0 (IQR 0?0.75; P<.001). Likewise, the median GQS among the useful and professional groups was evaluated at 2 (IQR 1.5?2) and 2 (IQR 1?2), respectively, eclipsing that of the unhelpful and nonprofessional groups at 1 (IQR 1?1) and 1 (IQR 1?1.37; P<.001). The GQS was weak and negatively correlated with the number of likes (r=?0.24; P=.004), comments (r=?0.29; P<.001), and saves (r=?0.20; P=.02). The mDISCERN score was weak and negatively correlated with the number of likes (r=?0.26; P=.002), comments (r=?0.36; P<.001), saves (r=?0.22; P=.009), and shares (r=?0.18; P=.03). Conclusions: The overall quality of mammography videos on Douyin is suboptimal, with most content uploaded by clinicians rather than radiologists. Radiologists should be encouraged to create accurate and informative videos to better educate patients. As Douyin grows as a health information platform, stricter publishing standards are needed to enhance the quality of medical content. UR - https://cancer.jmir.org/2025/1/e59483 UR - http://dx.doi.org/10.2196/59483 ID - info:doi/10.2196/59483 ER - TY - JOUR AU - Srivastava, Aditi AU - Stimpson, P. Jim PY - 2025/2/19 TI - Instagram Posts Promoting Colorectal Cancer Awareness: Content Analysis of Themes and Engagement During Colorectal Cancer Awareness Month JO - JMIR Form Res SP - e63344 VL - 9 KW - social media KW - colorectal neoplasms KW - early detection of cancer KW - public health KW - health inequities KW - harnessing KW - Instagram KW - colorectal cancer KW - colorectal cancer awareness KW - content analysis KW - cancer-related deaths KW - detection KW - screening KW - mortality KW - post KW - early detection N2 - Background: Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, with early detection and screening being critical for reducing mortality. Social media platforms like Instagram offer a unique opportunity to raise awareness about CRC, particularly during designated awareness months. However, there is limited research on the effectiveness of CRC-related content on Instagram. Objective: This study aims to examine how Instagram is used to raise awareness about CRC during Colorectal Cancer Awareness Month by analyzing the thematic content and engagement metrics of related posts. The research seeks to identify the prevalent themes, assess audience interaction with these messages, and highlight areas for improvement in leveraging Instagram as a tool for cancer awareness campaigns. Methods: A total of 150 Instagram posts were collected based on their use of specific hashtags related to CRC awareness (#colorectalcancer, #colorectalcancerawareness, #colorectalcancerawarenessmonth) during March 2024. The text and images in the posts were categorized into themes such as screening and early detection, symptoms, general awareness, risk factors, individual?s experiences, representation of racial and ethnic minoritized communities, and representation of women. Engagement metrics, including the number of likes and comments, were also analyzed. Two researchers independently coded the posts, achieving high interrater reliability (Cohen ?=0.93). Results: Organizational accounts were more active, contributing 82% (n=123) of the 150 posts, compared to 18% (n=27) from individual users. The most frequently mentioned theme was screening and early detection, which made up 37.3% (n=56) of all posts. General awareness came in second at 19.3% (n=29), and risk factors came in third at 12% (n=18). Posts about individual experiences and general awareness received the highest engagement, indicating the effectiveness of personal narratives and broad informational content. Themes related to symptoms and representation of racial and ethnic minoritized communities and women were underrepresented. Conclusions: This study highlights the potential of Instagram as a platform for promoting CRC awareness, particularly through posts about screening and early detection and personal experiences. However, there is a need for more inclusive and diverse content to ensure a broader reach and impact. UR - https://formative.jmir.org/2025/1/e63344 UR - http://dx.doi.org/10.2196/63344 ID - info:doi/10.2196/63344 ER - TY - JOUR AU - Niu, Zheyu AU - Hao, Yijie AU - Yang, Faji AU - Jiang, Qirong AU - Jiang, Yupeng AU - Zhang, Shizhe AU - Song, Xie AU - Chang, Hong AU - Zhou, Xu AU - Zhu, Huaqiang AU - Gao, Hengjun AU - Lu, Jun PY - 2024/12/11 TI - Quality of Pancreatic Neuroendocrine Tumor Videos Available on TikTok and Bilibili: Content Analysis JO - JMIR Form Res SP - e60033 VL - 8 KW - pancreatic neuroendocrine tumors KW - short videos KW - quality analysis KW - TikTok KW - Bilibili KW - social media N2 - Background: Disseminating disease knowledge through concise videos on various platforms is an innovative and efficient approach. However, it remains uncertain whether pancreatic neuroendocrine tumor (pNET)-related videos available on current short video platforms can effectively convey accurate and impactful information to the general public. Objective: Our study aims to extensively analyze the quality of pNET-related videos on TikTok and Bilibili, intending to enhance the development of pNET-related social media content to provide the general public with more comprehensive and suitable avenues for accessing pNET-related information. Methods: A total of 168 qualifying videos pertaining to pNETs were evaluated from the video-sharing platforms Bilibili and TikTok. Initially, the fundamental information conveyed in the videos was documented. Subsequently, we discerned the source and content type of each video. Following that, the Global Quality Scale (GQS) and modified DISCERN (mDISCERN) scale were employed to appraise the educational value and quality of each video. A comparative evaluation was conducted on the videos obtained from these two platforms. Results: The number of pNET-related videos saw a significant increase since 2020, with 9 videos in 2020, 19 videos in 2021, 29 videos in 2022, and 106 videos in 2023. There were no significant improvements in the mean GQS or mDISCERN scores from 2020 to 2023, which were 3.22 and 3.00 in 2020, 3.33 and 2.94 in 2021, 2.83 and 2.79 in 2022, and 2.78 and 2.94 in 2023, respectively. The average quality scores of the videos on Bilibili and Tiktok were comparable, with GQS and mDISCERN scores of 2.98 on Bilibili versus 2.77 on TikTok and 2.82 on Bilibili versus 3.05 on TikTok, respectively. The source and format of the videos remained independent factors affecting the two quality scores. Videos that were uploaded by professionals (hazard ratio=7.02, P=.002) and recorded in specialized popular science formats (hazard ratio=12.45, P<.001) tended to exhibit superior quality. Conclusions: This study demonstrates that the number of short videos on pNETs has increased in recent years, but video quality has not improved significantly. This comprehensive analysis shows that the source and format of videos are independent factors affecting video quality, which provides potential measures for improving the quality of short videos. UR - https://formative.jmir.org/2024/1/e60033 UR - http://dx.doi.org/10.2196/60033 ID - info:doi/10.2196/60033 ER - TY - JOUR AU - Gong, Jie AU - Gu, Dandan AU - Dong, Suyun AU - Shen, Wangqin AU - Yan, Haiou AU - Xie, Juan PY - 2024/11/7 TI - Effects of Message Framing on Human Papillomavirus Vaccination: Systematic Review JO - J Med Internet Res SP - e52738 VL - 26 KW - message framing KW - gain-loss framing KW - human papillomavirus KW - vaccination KW - attitude KW - intention KW - behavior KW - systematic review KW - PRISMA N2 - Background: With the advancement of cervical cancer elimination strategies, promoting human papillomavirus (HPV) vaccination is essential to achieving this goal. The issue of how to structure and develop message content to promote HPV vaccination is a debatable issue. Objective: The efficacy of gain-loss framing in vaccination contexts is disputed. Our study aimed to elucidate the consequences of message framing on attitudes, intentions, and behavioral tendencies toward HPV vaccination, with the objective of refining message framing strategies and their elements. Methods: This systematic review adhered strictly to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guideline reporting standards to comprehensively retrieve, extract, and integrate data. We searched databases, including PubMed, Embase, Scopus, and Web of Science, for literature published from database construction to August 15, 2023. Literature screening, data extraction, and quality evaluation were performed by 2 researchers. Intervention studies published in English, conducted with populations with children eligible for HPV vaccination, and involving message framing were included. Attitudes, intentions, and behaviors served as outcome evaluation criteria. Results: A total of 19 intervention studies were included. Gain-loss framing had no clear effect on vaccination attitudes nor intentions. Loss framing showed a weak advantage at improving HPV vaccination attitudes or intentions, but the evidence was not strong enough to draw definitive conclusions. The impact of gain-loss framing on HPV vaccination behaviors could not be determined due to the limited number of studies and the qualitative nature of the analysis. Conclusions: Combining gain-loss framing with other message framing approaches may be an effective way to enhance the effect of message framing. More high-quality message framing content and exploring alternative moderator or mediator variables are required to support the conclusion. Trial Registration: CRD42023451612; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=451612 UR - https://www.jmir.org/2024/1/e52738 UR - http://dx.doi.org/10.2196/52738 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/52738 ER - TY - JOUR AU - Kaneda, Yudai AU - Ozaki, Akihiko AU - Murakami, Michio AU - Sawano, Toyoaki AU - Nomura, Shuhei AU - Bhandari, Divya AU - Saito, Hiroaki AU - Tsubokura, Masaharu AU - Yamaoka, Kazue AU - Nakata, Yoshinori AU - Tsukada, Manabu AU - Ohira, Hiromichi PY - 2024/8/21 TI - Health Information Seeking on the Internet Among Patients With and Without Cancer in a Region Affected by the 2011 Fukushima Triple Disaster: Cross-Sectional Study JO - JMIR Cancer SP - e49897 VL - 10 KW - health information KW - patients with cancer KW - disaster KW - Japan KW - internet KW - patient with cancer KW - cancer KW - internet health KW - mobile phone N2 - Background: Health information seeking via the internet among patients with cancer in disaster-affected areas is underresearched. Objective: This study aims not only to assess the extent and means of web-based health information seeking among patients with cancer living in the disaster-affected area of the 2011 Fukushima triple disaster but also to compare these patterns with those without cancer, identifying distinct and shared factors influencing their web-based health information behaviors. Methods: We surveyed 404 patients (263 with and 141 without cancer) from the surgery department outpatient office at Minamisoma Municipal General Hospital, from October 2016 to January 2017. The survey included self-administered questions on internet and digital device use. Descriptive analyses were performed to examine the use patterns of digital devices and the internet and their impact on health information seeking across different age groups of patients with and without cancer. Multivariable logistic regression was used to examine factors associated with web-based health information seeking, stratifying by cancer diagnosis. Results: The proportion of participants who sought health information on the internet was comparable between patients with cancer and patients without cancer (19% vs 17.4%; P=.71). Digital device use varied significantly with age, with peak smartphone use occurring among the youngest cohorts for both groups. Multivariable logistic regression revealed that patients with cancer using smartphones or tablets daily were significantly more likely to gather web-based health information (odds ratio [OR] for smartphones 3.73, 95% CI 1.58-8.80; OR for tablets 5.08, 95% CI 1.27-20.35). Trust in institutional websites also significantly influenced web-based health information gathering among patients with cancer (OR 2.87, 95% CI 1.13-7.25). Conversely, among patients without cancer, unemployment was associated with a lower likelihood of seeking web-based health information (OR 0.26, 95% CI 0.08-0.85), whereas trust in both institutional and personal websites significantly increased this likelihood (OR for institutional websites 6.76, 95% CI 2.19-20.88; OR for personal websites 6.97, 95% CI 1.49-32.58). Conclusions: This study reveals that a small proportion of both patients with cancer and patients without cancer engage in health information seeking via the internet, influenced by age, digital device use, and trust in institutional websites. Given the growing prevalence of digital literacy, strategies to enhance accessible and reliable web-based health information should be developed, particularly for patients with cancer in postdisaster settings. Future efforts should focus on tailored health communication strategies that address the unique needs of these populations. UR - https://cancer.jmir.org/2024/1/e49897 UR - http://dx.doi.org/10.2196/49897 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/49897 ER - TY - JOUR AU - Zhao, Keyang AU - Li, Xiaojing AU - Li, Jingyang PY - 2024/8/14 TI - Cancer Prevention and Treatment on Chinese Social Media: Machine Learning?Based Content Analysis Study JO - J Med Internet Res SP - e55937 VL - 26 KW - social media KW - cancer information KW - text mining KW - supervised machine learning KW - content analysis N2 - Background: Nowadays, social media plays a crucial role in disseminating information about cancer prevention and treatment. A growing body of research has focused on assessing access and communication effects of cancer information on social media. However, there remains a limited understanding of the comprehensive presentation of cancer prevention and treatment methods across social media platforms. Furthermore, research comparing the differences between medical social media (MSM) and common social media (CSM) is also lacking. Objective: Using big data analytics, this study aims to comprehensively map the characteristics of cancer treatment and prevention information on MSM and CSM. This approach promises to enhance cancer coverage and assist patients in making informed treatment decisions. Methods: We collected all posts (N=60,843) from 4 medical WeChat official accounts (accounts with professional medical backgrounds, classified as MSM in this paper) and 5 health and lifestyle WeChat official accounts (accounts with nonprofessional medical backgrounds, classified as CSM in this paper). We applied latent Dirichlet allocation topic modeling to extract cancer-related posts (N=8427) and identified 6 cancer themes separately in CSM and MSM. After manually labeling posts according to our codebook, we used a neural-based method for automated labeling. Specifically, we framed our task as a multilabel task and utilized different pretrained models, such as Bidirectional Encoder Representations from Transformers (BERT) and Global Vectors for Word Representation (GloVe), to learn document-level semantic representations for labeling. Results: We analyzed a total of 4479 articles from MSM and 3948 articles from CSM related to cancer. Among these, 35.52% (2993/8427) contained prevention information and 44.43% (3744/8427) contained treatment information. Themes in CSM were predominantly related to lifestyle, whereas MSM focused more on medical aspects. The most frequently mentioned prevention measures were early screening and testing, healthy diet, and physical exercise. MSM mentioned vaccinations for cancer prevention more frequently compared with CSM. Both types of media provided limited coverage of radiation prevention (including sun protection) and breastfeeding. The most mentioned treatment measures were surgery, chemotherapy, and radiotherapy. Compared with MSM (1137/8427, 13.49%), CSM (2993/8427, 35.52%) focused more on prevention. Conclusions: The information about cancer prevention and treatment on social media revealed a lack of balance. The focus was primarily limited to a few aspects, indicating a need for broader coverage of prevention measures and treatments in social media. Additionally, the study?s findings underscored the potential of applying machine learning to content analysis as a promising research approach for mapping key dimensions of cancer information on social media. These findings hold methodological and practical significance for future studies and health promotion. UR - https://www.jmir.org/2024/1/e55937 UR - http://dx.doi.org/10.2196/55937 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/55937 ER - TY - JOUR AU - Ramadan, Majed AU - Aboalola, Doaa AU - Aouabdi, Sihem AU - Alghamdi, Tariq AU - Alsolami, Mona AU - Samkari, Alaa AU - Alsiary, Rawiah PY - 2024/8/12 TI - Influence of Breast Cancer Awareness Month on Public Interest of Breast Cancer in High-Income Countries Between 2012 and 2022: Google Trends Analysis JO - JMIR Cancer SP - e49197 VL - 10 KW - Google Trends KW - breast cancer KW - pandemic KW - awareness KW - public interest KW - cancer KW - cancer awareness KW - women KW - mortality rate KW - detection KW - treatment KW - social media KW - tool KW - education KW - support KW - internet users N2 - Background: Breast cancer is the most common cancer among women worldwide. High-income countries have a greater incidence and mortality rate of breast cancer than low-income countries. As a result, raising awareness about breast cancer is crucial in increasing the chances of early detection and treatment. Social media has evolved into an essential tool for Breast Cancer Awareness Month campaigns, allowing people to share their breast cancer stories and experiences while also providing a venue for education and support. Objective: The aim of this study was to assess the level of public interest in searches linked to breast cancer among a sample of high-income nations with a sizable internet user base from 2012 to 2022. We also sought to compare the proportional search volume for breast cancer during Breast Cancer Awareness Month with that during other months of the year. Methods: Google Trends was used to retrieve data on internet user search behaviors in the context of breast cancer from 2012 to 2022. Seven countries were evaluated in this study: Australia, Canada, Ireland, New Zealand, the United Kingdom, Saudi Arabia, and the United States, in addition to global data. Breast cancer relative search volume trends were analyzed annually, monthly, and weekly from 2012 to 2022. The annual percent change (APC) was calculated for each country and worldwide. Monthly and weekly data were used to identify potential trends. Results: A fluctuating pattern in APC rates was observed, with a notable increase in 2018 and a significant decrease in 2020, particularly in Saudi Arabia. Monthly analysis revealed a consistent peak in search volume during October (Breast Cancer Awareness Month) each year. Weekly trends over a 20-year period indicated significant decreases in Australia, Canada, New Zealand, and the United States, while increases were noted in Ireland. Heatmap analysis further highlighted a consistent elevation in median search volume during October across all countries. Conclusions: These findings underscore the impact of Breast Cancer Awareness Month and suggest potential influences of governmental COVID-19 pandemic control measures in 2020 on internet search behavior. UR - https://cancer.jmir.org/2024/1/e49197 UR - http://dx.doi.org/10.2196/49197 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/49197 ER - TY - JOUR AU - Pan, Peng AU - Yu, Changhua AU - Li, Tao AU - Dai, Tingting AU - Tian, Hanhan AU - Xiong, Yaozu AU - Lv, Jie AU - Hu, Xiaochu AU - Ma, Weidong AU - Yin, Wenda PY - 2024/5/30 TI - Evaluating the Quality of Cancer-Related WeChat Public Accounts: Cross-Sectional Study JO - JMIR Cancer SP - e52156 VL - 10 KW - cancer KW - big data KW - social media KW - health literacy KW - WeChat KW - China KW - public health N2 - Background: WeChat (Tencent) is one of the most important information sources for Chinese people. Relevantly, various health-related data are constantly transmitted among WeChat users. WeChat public accounts (WPAs) for health are rapidly emerging. Health-related WeChat public accounts have a significant impact on public health. Because of the rise in web-based health-seeking behavior, the general public has grown accustomed to obtaining cancer information from WPAs. Although WPAs make it easy for people to obtain health information, the quality of the information is questionable. Objective: This study aims to assess the quality and suitability of cancer-related WeChat public accounts (CWPAs). Methods: The survey was conducted from February 1 to 28, 2023. Based on the WPA monthly list provided by Qingbo Big Data, 28 CWPAs in the WeChat communication index were selected as the survey sample. Quality assessment of the included CWPAs was performed using the HONcode instrument. Furthermore, suitability was measured by using the Suitability Assessment of Materials. A total of 2 researchers conducted the evaluations independently. Results: Of the 28 CWPAs, 12 (43%) were academic and 16 (57%) were commercial. No statistical difference was found regarding the HONcode scores between the 2 groups (P=.96). The quality of the academic and commercial CWPAs evaluated using the HONcode instrument demonstrated mean scores of 5.58 (SD 2.02) and 5.63 (SD 2.16), respectively, corresponding to a moderate class. All CWPAs? compliance with the HONcode principles was unsatisfactory. A statistically significant difference between the 2 groups was observed in the Suitability Assessment of Materials scores (P=.04). The commercial WPAs reached an overall 55.1% (SD 5.5%) score versus the 50.2% (SD 6.4%) score reached by academic WPAs. The suitability of academic and commercial CWPAs was considered adequate. Conclusions: This study revealed that CWPAs are not sufficiently credible. WPA owners must endeavor to create reliable health websites using approved tools such as the HONcode criteria. However, it is necessary to educate the public about the evaluation tools of health websites to assess their credibility before using the provided content. In addition, improving readability will allow the public to read and understand the content. UR - https://cancer.jmir.org/2024/1/e52156 UR - http://dx.doi.org/10.2196/52156 UR - http://www.ncbi.nlm.nih.gov/pubmed/38814688 ID - info:doi/10.2196/52156 ER - TY - JOUR AU - Lau, Nancy AU - Zhao, Xin AU - O'Daffer, Alison AU - Weissman, Hannah AU - Barton, Krysta PY - 2024/5/7 TI - Pediatric Cancer Communication on Twitter: Natural Language Processing and Qualitative Content Analysis JO - JMIR Cancer SP - e52061 VL - 10 KW - cancer KW - COVID-19 KW - Twitter KW - communication KW - child health KW - caregivers KW - social media KW - tweet KW - tweets KW - sentiment KW - oncology KW - cancers KW - pediatric KW - pediatrics KW - child KW - children? youth KW - experience KW - experiences KW - attitude KW - attitudes KW - opinion KW - opinions KW - perception KW - perceptions KW - perspective KW - perspectives N2 - Background: During the COVID-19 pandemic, Twitter (recently rebranded as ?X?) was the most widely used social media platform with over 2 million cancer-related tweets. The increasing use of social media among patients and family members, providers, and organizations has allowed for novel methods of studying cancer communication. Objective: This study aimed to examine pediatric cancer?related tweets to capture the experiences of patients and survivors of cancer, their caregivers, medical providers, and other stakeholders. We assessed the public sentiment and content of tweets related to pediatric cancer over a time period representative of the COVID-19 pandemic. Methods: All English-language tweets related to pediatric cancer posted from December 11, 2019, to May 7, 2022, globally, were obtained using the Twitter application programming interface. Sentiment analyses were computed based on Bing, AFINN, and NRC lexicons. We conducted a supplemental nonlexicon-based sentiment analysis with ChatGPT (version 3.0) to validate our findings with a random subset of 150 tweets. We conducted a qualitative content analysis to manually code the content of a random subset of 800 tweets. Results: A total of 161,135 unique tweets related to pediatric cancer were identified. Sentiment analyses showed that there were more positive words than negative words. Via the Bing lexicon, the most common positive words were support, love, amazing, heaven, and happy, and the most common negative words were grief, risk, hard, abuse, and miss. Via the NRC lexicon, most tweets were categorized under sentiment types of positive, trust, and joy. Overall positive sentiment was consistent across lexicons and confirmed with supplemental ChatGPT (version 3.0) analysis. Percent agreement between raters for qualitative coding was 91%, and the top 10 codes were awareness, personal experiences, research, caregiver experiences, patient experiences, policy and the law, treatment, end of life, pharmaceuticals and drugs, and survivorship. Qualitative content analysis showed that Twitter users commonly used the social media platform to promote public awareness of pediatric cancer and to share personal experiences with pediatric cancer from the perspective of patients or survivors and their caregivers. Twitter was frequently used for health knowledge dissemination of research findings and federal policies that support treatment and affordable medical care. Conclusions: Twitter may serve as an effective means for researchers to examine pediatric cancer communication and public sentiment around the globe. Despite the public mental health crisis during the COVID-19 pandemic, overall sentiments of pediatric cancer?related tweets were positive. Content of pediatric cancer tweets focused on health and treatment information, social support, and raising awareness of pediatric cancer. UR - https://cancer.jmir.org/2024/1/e52061 UR - http://dx.doi.org/10.2196/52061 UR - http://www.ncbi.nlm.nih.gov/pubmed/38713506 ID - info:doi/10.2196/52061 ER - TY - JOUR AU - Peri?, Zinaida AU - Basak, Grzegorz AU - Koenecke, Christian AU - Moiseev, Ivan AU - Chauhan, Jyoti AU - Asaithambi, Sathyaraj AU - Sagkriotis, Alexandros AU - Gunes, Sibel AU - Penack, Olaf PY - 2023/11/10 TI - Understanding the Needs and Lived Experiences of Patients With Graft-Versus-Host Disease: Real-World European Public Social Media Listening Study JO - JMIR Cancer SP - e42905 VL - 9 KW - graft-versus-host disease KW - GVHD KW - infoveillance KW - patient journey KW - quality of life KW - real-world evidence KW - social media listening KW - social media N2 - Background: Graft-versus-host disease (GVHD) is the major cause of short- and long-term morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Treatment options beyond corticosteroid therapy remain limited, and prolonged treatment often leads to impaired quality of life (QoL). A better understanding of the needs and experiences of patients with GVHD is required to improve patient care. Objective: The aim of this study is to explore different social media (SM) channels for gathering and analyzing the needs and experiences of patients and other stakeholders across 14 European countries. Methods: We conducted a retrospective analysis of SM data from the public domain. The Talkwalker social analytics tool collected data from open-access forums, blogs, and various social networking sites using predefined search strings. The raw data set derived from the aggregator tool was automatically screened for the relevancy of posts, generating the curated data set that was manually reviewed to identify posts that fell within the predefined inclusion and exclusion criteria. This final data set was then used for the deep-dive analysis. Results: A total of 9016 posts relating to GVHD were identified between April 2019 and April 2021. Deduplication and relevancy checks resulted in 325 insightful posts, with Twitter contributing 250 (77%) posts; blogs, 49 (15%) posts; forums, 13 (4%) posts; Facebook, 7 (2%) posts; and Instagram and YouTube, 4 (1%) posts. Patients with GVHD were the primary stakeholders, contributing 63% of all SM posts. In 234 posts, treatment was the most discussed stage of the patient journey (68%), followed by symptoms (33%), and diagnosis and tests (21%). Among treatment-related posts (n=159), steroid therapy was most frequently reported (54/159, 34%). Posts relating to treatment features (n=110) identified efficacy (45/110, 41%), side effects (38/110, 35%), and frequency and dosage (32/110, 29%), as the most frequently discussed features. Symptoms associated with GVHD were described in 24% (77/325) of posts, including skin-related conditions (49/77, 64%), dry eyes or vision change (13/77, 17%), pain and cramps (16/77, 21%), and fatigue or muscle weakness (12/77, 16%). The impacts of GVHD on QoL were discussed in 51% (165/325) of all posts, with the emotional, physical and functional, social, and financial impacts mentioned in 69% (114/165), 50% (82/165), 5% (8/165), and 2% (3/165) of these posts, respectively. Unmet needs were reported by patients or caregivers in 24% (77/325) of analyzed conversations, with treatment-related side effects being the most common (35/77, 45%) among these posts. Conclusions: SM listening is a useful tool to identify medical needs. Treatment of GVHD, including treatment-related side effects, as well as its emotional and physical impact on QoL, are the major topics that GVHD stakeholders mention on SM. We encourage a structured discussion of these topics in interactions between health care providers and patients with GVHD. Trial Registration: Not applicable UR - https://cancer.jmir.org/2023/1/e42905 UR - http://dx.doi.org/10.2196/42905 UR - http://www.ncbi.nlm.nih.gov/pubmed/37948101 ID - info:doi/10.2196/42905 ER - TY - JOUR AU - Lazard, J. Allison AU - Nicolla, Sydney AU - Vereen, N. Rhyan AU - Pendleton, Shanetta AU - Charlot, Marjory AU - Tan, Hung-Jui AU - DiFranzo, Dominic AU - Pulido, Marlyn AU - Dasgupta, Nabarun PY - 2023/7/28 TI - Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study JO - JMIR Cancer SP - e43749 VL - 9 KW - cancer KW - misinformation KW - social media KW - prosocial intervening KW - treatment KW - false information KW - alternative medicine KW - information spread KW - dissemination KW - infodemiology KW - mobile phone N2 - Background: Cancer treatment misinformation, or false claims about alternative cures, often spreads faster and farther than true information on social media. Cancer treatment misinformation can harm the psychosocial and physical health of individuals with cancer and their cancer care networks by causing distress and encouraging people to abandon support, potentially leading to deviations from evidence-based care. There is a pressing need to understand how cancer treatment misinformation is shared and uncover ways to reduce misinformation. Objective: We aimed to better understand exposure and reactions to cancer treatment misinformation, including the willingness of study participants to prosocially intervene and their intentions to share Instagram posts with cancer treatment misinformation. Methods: We conducted a survey on cancer treatment misinformation among US adults in December 2021. Participants reported their exposure and reactions to cancer treatment misinformation generally (saw or heard, source, type of advice, and curiosity) and specifically on social media (platform, believability). Participants were then randomly assigned to view 1 of 3 cancer treatment misinformation posts or an information post and asked to report their willingness to prosocially intervene and their intentions to share. Results: Among US adult participants (N=603; mean age 46, SD 18.83 years), including those with cancer and cancer caregivers, almost 1 in 4 (142/603, 23.5%) received advice about alternative ways to treat or cure cancer. Advice was primarily shared through family (39.4%) and friends (37.3%) for digestive (30.3%) and natural (14.1%) alternative cancer treatments, which generated curiosity among most recipients (106/142, 74.6%). More than half of participants (337/603, 55.9%) saw any cancer treatment misinformation on social media, with significantly higher exposure for those with cancer (53/109, 70.6%) than for those without cancer (89/494, 52.6%; P<.001). Participants saw cancer misinformation on Facebook (39.8%), YouTube (27%), Instagram (22.1%), and TikTok (14.1%), among other platforms. Participants (429/603, 71.1%) thought cancer treatment misinformation was true, at least sometimes, on social media. More than half (357/603, 59.2%) were likely to share any cancer misinformation posts shown. Many participants (412/603, 68.3%) were willing to prosocially intervene for any cancer misinformation posts, including flagging the cancer treatment misinformation posts as false (49.7%-51.4%) or reporting them to the platform (48.1%-51.4%). Among the participants, individuals with cancer and those who identified as Black or Hispanic reported greater willingness to intervene to reduce cancer misinformation but also higher intentions to share misinformation. Conclusions: Cancer treatment misinformation reaches US adults through social media, including on widely used platforms for support. Many believe that social media posts about alternative cancer treatment are true at least some of the time. The willingness of US adults, including those with cancer and members of susceptible populations, to prosocially intervene could initiate the necessary community action to reduce cancer treatment misinformation if coupled with strategies to help individuals discern false claims. UR - https://cancer.jmir.org/2023/1/e43749 UR - http://dx.doi.org/10.2196/43749 UR - http://www.ncbi.nlm.nih.gov/pubmed/37505790 ID - info:doi/10.2196/43749 ER - TY - JOUR AU - Grewal, Singh Udhayvir AU - Gupta, Arjun AU - Doggett, Jamie AU - Lou, Emil AU - Gusani, J. Niraj AU - Maitra, Anirban AU - Beg, Shaalan Muhammad AU - Ocean, J. Allyson PY - 2022/3/24 TI - Twitter Conversations About Pancreatic Cancer by Health Care Providers and the General Public: Thematic Analysis JO - JMIR Cancer SP - e31388 VL - 8 IS - 1 KW - pancreatic cancer KW - Twitter KW - general public KW - health care providers KW - social media KW - Creation Pinpoint KW - thematic analysis N2 - Background:  There is a growing interest in the pattern of consumption of health-related information on social media platforms. Objective: We evaluated the content of discussions around pancreatic cancer on Twitter to identify subtopics of greatest interest to health care providers and the general public.  Methods:  We used an online analytical tool (Creation Pinpoint) to quantify Twitter mentions (tweets and retweets) related to pancreatic cancer between January 2018 and December 2019. Keywords, hashtags, word combinations, and phrases were used to identify mentions. Health care provider profiles were identified using machine learning and then verified by a human analyst. Remaining user profiles were classified as belonging to the general public. Data from conversations were stratified qualitatively into 5 domains: (1) prevention, (2) survivorship, (3) treatment, (4) research, and (5) policy. We compared the themes of conversations initiated by health care providers and the general public and analyzed the impact of the Pancreatic Cancer Awareness Month and announcements by public figures of pancreatic cancer diagnoses on the overall volume of conversations.  Results:  Out of 1,258,028 mentions of pancreatic cancer, 313,668 unique mentions were classified into the 5 domains. We found that health care providers most commonly discussed pancreatic cancer research (10,640/27,031 mentions, 39.4%), while the general public most commonly discussed treatment (154,484/307,449 mentions, 50.2%). Health care providers were found to be more likely to initiate conversations related to research (odds ratio [OR] 1.75, 95% CI 1.70-1.79, P<.001) and prevention (OR 1.49, 95% CI 1.41-1.57, P<.001) whereas the general public took the lead in the domains of treatment (OR 1.63, 95% CI 1.58-1.69, P<.001) and survivorship (OR 1.17, 95% CI 1.13-1.21, P<.001). Pancreatic Cancer Awareness Month did not increase the number of mentions by health care providers in any of the 5 domains, but general public mentions increased temporarily in all domains except prevention and policy. Health care provider mentions did not increase with announcements by public figures of pancreatic cancer diagnoses. After Alex Trebek, host of the television show Jeopardy, received his diagnosis, general public mentions of survivorship increased, while Justice Ruth Bader Ginsburg?s diagnosis increased conversations on treatment.  Conclusions: Health care provider conversations on Twitter are not aligned with the general public. Pancreatic Cancer Awareness Month temporarily increased general public conversations about treatment, research, and survivorship, but not prevention or policy. Future studies are needed to understand how conversations on social media platforms can be leveraged to increase health care awareness among the general public. UR - https://cancer.jmir.org/2022/1/e31388 UR - http://dx.doi.org/10.2196/31388 UR - http://www.ncbi.nlm.nih.gov/pubmed/35323123 ID - info:doi/10.2196/31388 ER - TY - JOUR AU - Loeb, Stacy AU - Massey, Philip AU - Leader, E. Amy AU - Thakker, Sameer AU - Falge, Emily AU - Taneja, Sabina AU - Byrne, Nataliya AU - Rose, Meredith AU - Joy, Matthew AU - Walter, Dawn AU - Katz, S. Matthew AU - Wong, L. Risa AU - Selvan, Preethi AU - Keith, W. Scott AU - Giri, N. Veda PY - 2021/9/20 TI - Gaps in Public Awareness About BRCA and Genetic Testing in Prostate Cancer: Social Media Landscape Analysis JO - JMIR Cancer SP - e27063 VL - 7 IS - 3 KW - genetic testing KW - BRCA KW - prostate cancer KW - breast cancer KW - social media KW - infodemiology N2 - Background: Genetic testing, particularly for BRCA1/2, is increasingly important in prostate cancer (PCa) care, with impact on PCa management and hereditary cancer risk. However, the extent of public awareness and online discourse on social media is unknown, and presents opportunities to identify gaps and enhance population awareness and uptake of advances in PCa precision medicine. Objective: The objective of this study was to characterize activity and engagement across multiple social media platforms (Twitter, Facebook, and YouTube) regarding BRCA and genetic testing for PCa compared with breast cancer, which has a long history of public awareness, advocacy, and prominent social media presence. Methods: The Symplur Signals online analytics platform was used to obtain metrics for tweets about (1) #BRCA and #breastcancer, (2) #BRCA and #prostatecancer, (3) #genetictesting and #breastcancer, and (4) #genetictesting and #prostatecancer from 2016 to 2020. We examined the total number of tweets, users, and reach for each hashtag, and performed content analysis for a subset of tweets. Facebook and YouTube were queried using analogous search terms, and engagement metrics were calculated. Results: During a 5-year period, there were 10,005 tweets for #BRCA and #breastcancer, versus 1008 tweets about #BRCA and #prostatecancer. There were also more tweets about #genetictesting and #breastcancer (n=1748), compared with #genetic testing and #prostatecancer (n=328). Tweets about genetic testing (12,921,954) and BRCA (75,724,795) in breast cancer also had substantially greater reach than those about PCa (1,463,777 and 4,849,905, respectively). Facebook groups and pages regarding PCa and BRCA/genetic testing had fewer average members, new members, and new posts, as well as fewer likes and followers, compared with breast cancer. Facebook videos had more engagement than YouTube videos across both PCa and breast cancer content. Conclusions: There is substantially less social media engagement about BRCA and genetic testing in PCa compared with breast cancer. This landscape analysis provides insights into strategies for leveraging social media platforms to increase public awareness about PCa germline testing, including use of Facebook to share video content and Twitter for discussions with health professionals. UR - https://cancer.jmir.org/2021/3/e27063 UR - http://dx.doi.org/10.2196/27063 UR - http://www.ncbi.nlm.nih.gov/pubmed/34542414 ID - info:doi/10.2196/27063 ER - TY - JOUR AU - Qin, Lei AU - Zhang, Xiaomei AU - Wu, Anlin AU - Miser, S. James AU - Liu, Yen-Lin AU - Hsu, C. Jason AU - Shia, Ben-Chang AU - Ye, Linglong PY - 2021/8/27 TI - Association Between Social Media Use and Cancer Screening Awareness and Behavior for People Without a Cancer Diagnosis: Matched Cohort Study JO - J Med Internet Res SP - e26395 VL - 23 IS - 8 KW - social media KW - cancer screening awareness KW - cancer screening behavior KW - gender-specific effects KW - propensity-score matching KW - general population N2 - Background: The use of social media in communications regarding cancer prevention is rapidly growing. However, less is known about the general population?s social media use related to cancer screening awareness and behavior for different cancers. Objective: We aimed to examine the relationship between social media use and cancer screening awareness and behavior among people without a cancer diagnosis. Methods: Data were collected from the Health Information National Trends Survey 5 Cycle 1 to 3 in the United States (n=12,227). Our study included 10,124 participants without a cancer diagnosis and 3 measures of screening awareness (those who had heard of hepatitis C virus [HCV], human papillomavirus [HPV], and the HPV vaccine) and 4 measures of behavior (those who had prostate-specific antigen tests, Papanicolaou tests for cervical cancer, as well as breast cancer and colon cancer tests). Propensity-score matching was conducted to adjust for the sociodemographic variables between the social media user and nonuser participants. Multivariable logistic regression was used to assess the association of social media use by gender. Jackknife replicate weights were incorporated into the analyses. Results: Of the 3794 matched participants, 1861 (57.6% weighted) were male, and the mean age was 55.5 (SD 0.42) years. Compared to social media nonusers, users were more likely to have heard of HCV (adjusted odds ratio [aOR]=2.27, 95% CI, 1.29-3.98 and aOR=2.86, 95% CI, 1.51-5.40, for male and female users, respectively) and HPV (aOR=1.82, 95% CI, 1.29-2.58 and aOR=2.35, 95% CI, 1.65-3.33, for male and female users, respectively). In addition, female users were more likely to have heard of the HPV vaccine (aOR=2.06, 95% CI, 1.41-3.00). No significant associations were found between social media use and prostate-specific antigen tests in males, Papanicolaou tests and breast cancer tests in females, or colon cancer tests in both male and female users. Conclusions: While social media services can potentially promote cancer screening awareness in the general population, but they did not improve screening behavior after adjusting for socioeconomic status. These findings strengthened our understanding of social media use in targeting health communications for different cancers. UR - https://www.jmir.org/2021/8/e26395 UR - http://dx.doi.org/10.2196/26395 UR - http://www.ncbi.nlm.nih.gov/pubmed/34448708 ID - info:doi/10.2196/26395 ER - TY - JOUR AU - Oakley-Girvan, Ingrid AU - Watterson, L. Jessica AU - Jones, Cheryl AU - Houghton, C. Lauren AU - Gibbons, P. Marley AU - Gokal, Kajal AU - Magsamen-Conrad, Kate PY - 2021/7/30 TI - Use of Social Media for Cancer Prevention Through Neighborhood Social Cohesion: Protocol for a Feasibility Study JO - JMIR Res Protoc SP - e28147 VL - 10 IS - 7 KW - social cohesion KW - mothers KW - neighborhood KW - physical activity KW - social media KW - social KW - behavior KW - health outcomes KW - socioeconomic status KW - community health KW - chronic disease KW - social network KW - feasibility KW - wellbeing KW - cancer N2 - Background: Social cohesion is associated with healthier behaviors and better health outcomes, and therefore may offer a mechanism for promoting better health. Low socioeconomic status (SES) communities face higher rates of chronic disease due to both community- and individual-level factors. Objective: The aim of this study is to leverage social cohesion to promote healthier behaviors and prevent chronic disease in a low SES community. This protocol outlines the methodology for a pilot study to assess the feasibility of an intervention (Free Time For Wellness [FT4W]) using a social networking platform (Nextdoor) with mothers living in an urban, low-income community to improve social cohesion and promote healthy behaviors. Methods: The study will involve three phases: (I) co-designing the intervention with mothers in the neighborhoods of interest, (II) implementing the intervention with community leaders through the social networking platform, and (III) evaluating the intervention?s feasibility. Phase I of the study will include qualitative data collection and analysis from in-depth, semistructured interviews and a co-design group session with mothers. Phases II and III of the study include a pre- and postintervention survey of participating mothers. Neighborhood-level data on social cohesion will also be collected to enable comparison of outcomes between neighborhoods with higher and lower baseline social cohesion. Results: As of March 2021, recruitment and data collection for this study are complete. This protocol outlines our original study plan, although the final enrollment numbers and intervention implementation deviated from our initial planned methodology that is outlined in this protocol. These implementation learnings will be shared in subsequent publications of our study results. Conclusions: Ultimately, this study aims to: (1) determine the barriers and facilitators to finding free time for wellness among a population of low-income mothers to inform the co-design process, and (2) implement and study the feasibility of an intervention that leverages social cohesion to promote physical activity in a community of low-income mothers. The results of this study will provide preliminary feasibility evidence to inform a larger effectiveness trial, and will further our understanding of how social cohesion might influence well-being. International Registered Report Identifier (IRRID): RR1-10.2196/28147 UR - https://www.researchprotocols.org/2021/7/e28147 UR - http://dx.doi.org/10.2196/28147 UR - http://www.ncbi.nlm.nih.gov/pubmed/34328445 ID - info:doi/10.2196/28147 ER - TY - JOUR AU - Zhang, Hongjie Thomas AU - Tham, Sern Jen PY - 2021/6/21 TI - Calls to Action (Mobilizing Information) on Cancer in Online News: Content Analysis JO - J Med Internet Res SP - e26019 VL - 23 IS - 6 KW - mobilizing information KW - online cancer news KW - quantitative content analysis KW - Malaysia KW - online news KW - cancer KW - infodemiology KW - media KW - digital media KW - digital health KW - health information KW - cancer health information N2 - Background: The health belief model explains that individual intentions and motivation of health behaviors are mostly subject to externalcues to action, such as from interpersonal communications and media consumptions. The concept of mobilizing information (MI) refers to a type of mediated information that could call individuals to carry out particular health actions. Different media channels, especially digital media outlets, play an essential role as a health educator to disseminate cancer health information and persuade and mobilize cancer prevention in the community. However, little is known about calls to action (or MI) in online cancer news, especially from Asian media outlets. Objective: This study aimed at analyzing cancer news articles that contain MI and their news components on the selected Malaysian English and Chinese newspapers with online versions. Methods: The Star Online and Sin Chew Online were selected for analysis because the two newspaper websites enjoy the highest circulation and readership in the English language and the Chinese language streams, respectively. Two bilingual coders searched the cancer news articles based on sampling keywords and then read and coded each news article accordingly. Five coding variables were conceptualized from previous studies (ie, cancer type, news source, news focus, cancer risk factors, and MI), and a good consistency using Cohen kappa was built between coders. Descriptive analysis was used to examine the frequency and percentage of each coding item; chi-square test (confidence level at 95%) was applied to analyze the differences between two newspaper websites, and the associations between variables and the presence of MI were examined through binary logistic regression. Results: Among 841 analyzed news articles, 69.6% (585/841) presented MI. News distributions were unbalanced throughout the year in both English and Chinese newspaper websites; some months occupied peaks (ie, February and October), but cancer issues and MI for cancer prevention received minimal attention in other months. The news articles from The Star Online and Sin Chew Online were significantly different in several news components, such as the MI present rates (?2=9.25, P=.003), providing different types of MI (interactive MI: ?2=12.08, P=.001), interviewing different news sources (government agency: ?2=12.05, P=.001), concerning different news focus (primary cancer prevention: ?2=10.98, P=.001), and mentioning different cancer risks (lifestyle risks: ?2=7.43, P=.007). Binary logistic regression results reported that online cancer news articles were more likely to provide MI when interviewing nongovernmental organizations, focusing on topics related to primary cancer prevention, and highlighting lifestyle risks (odds ratio [OR] 2.77, 95% CI 1.89-4.05; OR 97.70, 95% CI 46.97-203.24; OR 186.28; 95% CI 44.83-773.96; P=.001, respectively). Conclusions: This study provided new understandings regarding MI in cancer news coverage. This could wake and trigger individuals? preexisting attitudes and intentions on cancer prevention. Thus, health professionals, health journalists, and health campaign designers should concentrate on MI when distributing health information to the community. UR - https://www.jmir.org/2021/6/e26019 UR - http://dx.doi.org/10.2196/26019 UR - http://www.ncbi.nlm.nih.gov/pubmed/34152283 ID - info:doi/10.2196/26019 ER - TY - JOUR AU - Moreno, Andreas Megan AU - Jenkins, C. Marina AU - Lazovich, DeAnn PY - 2021/5/19 TI - Tanning Misinformation Posted by Businesses on Social Media and Related Perceptions of Adolescent and Young Adult White Non-Hispanic Women: Mixed Methods Study JO - JMIR Dermatol SP - e25661 VL - 4 IS - 1 KW - adolescent KW - social media KW - tanning KW - technology KW - media N2 - Background: Indoor ultraviolet (UV) tanning is common and consequential, increasing the risk for cancers including melanoma and basal cell carcinoma. At-risk groups include adolescents and young adults, who often report beliefs about benefits of tanning. Adolescent and young adults are also among the most ubiquitous social media users. As previous studies support that content about tanning is common on social media, this may be a way that young women are exposed to influential content promoting tanning, including health misinformation. Objective: The purpose of this study was to evaluate health misinformation promoted by indoor tanning businesses via social media and to understand young women?s perceptions of this misinformation. Methods: This mixed methods study included (1) retrospective observational content analysis of indoor tanning salons? content on Facebook over 1 year and (2) qualitative interviews with a purposeful national sample of 46 White non-Hispanic women, age 16 to 23 years, who had recently tanned indoors. We assessed experiences with tanning businesses? posted content on social media through interviews. We used the constant comparative approach for qualitative analyses. Results: Content analysis findings included data from indoor tanning businesses (n=147) across 50 states, yielding 4956 total posts. Among 9 health misinformation topics identified, the most common was the promotion of UV tanning as a safe way to get Vitamin D (n=73, 1.5%). An example post was ?Stop by Body and Sol to get your daily dose of Vitamin D.? Another misinformation topic was promoting tanning for health benefits (n=31, 0.62%), an example post was ?the flu is not a season, it?s an inability to adapt due to decreased sun exposure?? A total of 46 participants completed interviews (age: mean 20 years, SD 2). Almost all participants (45/46, 98%) used Facebook, and 43.5% (20/46) followed an indoor tanning business on social media. Approximately half of participants reported seeing social media posts from tanning salons about Vitamin D, an example of a participant comment was ?I have [seen that] a few times...? Among the participants, approximately half believed it was safe to get Vitamin D from indoor UV tanning; a participant stated: ?I think it is a valid benefit to UV tanning.? Conclusions: Despite the low frequency (range 0.5%-1.5%) of social media posts promoting health misinformation, participants commonly reported viewing these posts, and their perceptions aligned with health misinformation. Health education campaigns, possibly using social media to target at-risk populations, may be an innovative approach for tanning prevention messages. UR - https://derma.jmir.org/2021/1/e25661 UR - http://dx.doi.org/10.2196/25661 UR - http://www.ncbi.nlm.nih.gov/pubmed/37632797 ID - info:doi/10.2196/25661 ER - TY - JOUR AU - Yaacob, Azwany Nor AU - Mohamad Marzuki, Fadhil Muhamad AU - Yaacob, Majdi Najib AU - Ahmad, Bariyah Shahrul AU - Abu Hassan, Radzi Muhammad PY - 2020/2/25 TI - Effectiveness of the ColorApp Mobile App for Health Education and Promotion for Colorectal Cancer: Quasi-Experimental Study JO - JMIR Hum Factors SP - e15487 VL - 7 IS - 1 KW - colorectal cancer KW - mobile app KW - effectiveness KW - knowledge KW - attitude N2 - Background: Lack of knowledge and poor attitude are barriers to colorectal cancer screening participation. Printed material, such as pamphlets and posters, have been the main approach in health education on disease prevention in Malaysia. Current information technology advancements have led to an increasing trend of the public reading from websites and mobile apps using their mobile phones. Thus, health information dissemination should also be diverted to websites and mobile apps. Increasing knowledge and awareness could increase screening participation and prevent late detection of diseases such as colorectal cancer. Objective: This study aimed to assess the effectiveness of the ColorApp mobile app in improving the knowledge and attitude on colorectal cancer among users aged 50 years and older, who are the population at risk for the disease in Kedah. Methods: A quasi-experimental study was conducted with 100 participants in Kedah, Malaysia. Participants from five randomly selected community empowerment programs in Kota Setar district were in the intervention group; Kuala Muda district was the control group. Participants were given a self-administered validated questionnaire on knowledge and attitudes toward colorectal cancer. A mobile app, ColorApp (Colorectal Cancer Application), was developed as a new educational tool for colorectal cancer prevention. The intervention group used the app for two weeks. The same questionnaire was redistributed to both groups after two weeks. The mean percentage scores for knowledge and attitude between groups were compared using repeated measure ANCOVA. Results: There was no significant difference in age, sex, highest education level, current occupation, and diabetic status between the two groups. The number of smokers was significantly higher in the intervention group compared with the control group and was controlled for during analysis. The intervention group showed a significantly higher mean knowledge score compared with the control group with regards to time (Huynh-Feldt: F1,95=19.81, P<.001). However, there was no significant difference in mean attitude scores between the intervention and control groups with regards to time (F1,95=0.36, P=.55). Conclusions: The ColorApp mobile app may be an adjunct approach in educating the public on colorectal cancer. UR - https://humanfactors.jmir.org/2020/1/e15487 UR - http://dx.doi.org/10.2196/15487 UR - http://www.ncbi.nlm.nih.gov/pubmed/32130119 ID - info:doi/10.2196/15487 ER - TY - JOUR AU - Biancovilli, Priscila AU - Jurberg, Claudia PY - 2018/12/18 TI - How to Optimize Health Messages About Cancer on Facebook: Mixed-Methods Study JO - JMIR Cancer SP - e11073 VL - 4 IS - 2 KW - cancer KW - content analysis KW - Facebook KW - health KW - software N2 - Background: Incidence rate of cancer is increasing worldwide, with longer life expectancy being one of the main causes. Yet, between 30% and 50% of cancer cases are preventable, and early detection contributes to a better prognosis. This makes health communication strategies essential. Facebook, the world?s most used social networking site in 2017 and 2018, can be a useful tool for disseminating powerful messages on health promotion, prevention, and early detection. Objective: We aimed to (1) offer ways of optimizing health messages about cancer on Facebook, focusing on topics, such as risk factors, prevention, treatment, early diagnosis, and cure, and (2) investigate which aspects of these messages generate greater engagement. Methods: To verify what generates greater engagement in topics related to cancer on Facebook, we analyzed 16 Brazilian pages with the main theme of cancer. We performed a manual analysis of texts, content, and engagement rates. Finally, we developed a software program to operationalize the analysis of Facebook posts. The tool we devised aims to automate the analysis of any Facebook page with cancer as the main theme. Results: We analyzed 712 posts over a 1-month period. We divided the posts into the following 8 categories: ?Testimonies or real-life stories,? ?Solidarity,? ?Anniversaries,? ?Science and health,? ?Events,? ?Institutional,? ?Risk factors,? and ?Beauty.? The pages were also organized into groups according to the type of profile to which they belonged (ie, hospitals or foundations, informative, nongovernmental organizations, and personal pages).The results showed that the categories generating greater engagement in Brazil were not those with the highest percentage of cancer-related content. For instance, in the ?Informative? group the ?Testimonies or real-life stories? category generated an engagement of 79.5%. However, only 9.5% (25/261) of the content within the relevant time period dealt with such topics. Another example concerns the category ?Science and health.? Despite being the one with the highest number of posts (129/261, 49.4%), it scored 5th in terms of engagement. This investigation served as the basis for the development of a tool designed to automate the analysis of Facebook pages. The list of categories and keywords generated by this analysis was employed to feed the system, which was then able to categorize posts appearing on a Facebook page. We tested the system on 163 posts and only 34 were classified incorrectly, which amounts to a 20.8% error rate (79.2% accuracy). Conclusions: The analysis we conducted by categorizing posts and calculating engagement rates shows that the potential of Facebook pages is often underutilized. This occurs because the categories that generate the greatest engagement are often not those most frequently used. The software developed in this research may help administrators of cancer-related pages analyze their posts more easily and increase public interest as a result. UR - http://cancer.jmir.org/2018/2/e11073/ UR - http://dx.doi.org/10.2196/11073 UR - http://www.ncbi.nlm.nih.gov/pubmed/30563821 ID - info:doi/10.2196/11073 ER - TY - JOUR AU - Lama, Yuki AU - Chen, Tao AU - Dredze, Mark AU - Jamison, Amelia AU - Quinn, Crouse Sandra AU - Broniatowski, A. David PY - 2018/09/14 TI - Discordance Between Human Papillomavirus Twitter Images and Disparities in Human Papillomavirus Risk and Disease in the United States: Mixed-Methods Analysis JO - J Med Internet Res SP - e10244 VL - 20 IS - 9 KW - disparities KW - health communication KW - HPV vaccines KW - image tweet KW - public health communication KW - social media KW - Twitter KW - visual communication N2 - Background: Racial and ethnic minorities are disproportionately affected by human papillomavirus (HPV)-related cancer, many of which could have been prevented with vaccination. Yet, the initiation and completion rates of HPV vaccination remain low among these populations. Given the importance of social media platforms for health communication, we examined US-based HPV images on Twitter. We explored inconsistencies between the demographics represented in HPV images and the populations that experience the greatest burden of HPV-related disease. Objective: The objective of our study was to observe whether HPV images on Twitter reflect the actual burden of disease by select demographics and determine to what extent Twitter accounts utilized images that reflect the burden of disease in their health communication messages. Methods: We identified 456 image tweets about HPV that contained faces posted by US users between November 11, 2014 and August 8, 2016. We identified images containing at least one human face and utilized Face++ software to automatically extract the gender, age, and race of each face. We manually annotated the source accounts of these tweets into 3 types as follows: government (38/298, 12.8%), organizations (161/298, 54.0%), and individual (99/298, 33.2%) and topics (news, health, and other) to examine how images varied by message source. Results: Findings reflected the racial demographics of the US population but not the disease burden (795/1219, 65.22% white faces; 140/1219, 11.48% black faces; 71/1219, 5.82% Asian faces; and 213/1219, 17.47% racially ambiguous faces). Gender disparities were evident in the image faces; 71.70% (874/1219) represented female faces, whereas only 27.89% (340/1219) represented male faces. Among the 11-26 years age group recommended to receive HPV vaccine, HPV images contained more female-only faces (214/616, 34.3%) than males (37/616, 6.0%); the remainder of images included both male and female faces (365/616, 59.3%). Gender and racial disparities were present across different image sources. Faces from government sources were more likely to depict females (n=44) compared with males (n=16). Of male faces, 80% (12/15) of youth and 100% (1/1) of adults were white. News organization sources depicted high proportions of white faces (28/38, 97% of female youth and 12/12, 100% of adult males). Face++ identified fewer faces compared with manual annotation because of limitations with detecting multiple, small, or blurry faces. Nonetheless, Face++ achieved a high degree of accuracy with respect to gender, race, and age compared with manual annotation. Conclusions: This study reveals critical differences between the demographics reflected in HPV images and the actual burden of disease. Racial minorities are less likely to appear in HPV images despite higher rates of HPV incidence. Health communication efforts need to represent populations at risk better if we seek to reduce disparities in HPV infection. UR - http://www.jmir.org/2018/9/e10244/ UR - http://dx.doi.org/10.2196/10244 UR - http://www.ncbi.nlm.nih.gov/pubmed/30217792 ID - info:doi/10.2196/10244 ER - TY - JOUR AU - Sarkar, Urmimala AU - Le, M. Gem AU - Lyles, R. Courtney AU - Ramo, Danielle AU - Linos, Eleni AU - Bibbins-Domingo, Kirsten PY - 2018/06/05 TI - Using Social Media to Target Cancer Prevention in Young Adults: Viewpoint JO - J Med Internet Res SP - e203 VL - 20 IS - 6 KW - cancer KW - prevention & control KW - young adult KW - behavior KW - social media UR - http://www.jmir.org/2018/6/e203/ UR - http://dx.doi.org/10.2196/jmir.8882 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/jmir.8882 ER - TY - JOUR AU - Jessup, L. Dana AU - Glover IV, McKinley AU - Daye, Dania AU - Banzi, Lynda AU - Jones, Philip AU - Choy, Garry AU - Shepard, O. Jo-Anne AU - Flores, J. Efrén PY - 2018/02/15 TI - Implementation of Digital Awareness Strategies to Engage Patients and Providers in a Lung Cancer Screening Program: Retrospective Study JO - J Med Internet Res SP - e52 VL - 20 IS - 2 KW - lung neoplasms KW - diagnostic imaging KW - social media KW - patient participation KW - search engine N2 - Background: Lung cancer is the leading cause of cancer-related deaths in the United States. Despite mandated insurance coverage for eligible patients, lung cancer screening rates remain low. Digital platforms, including social media, provide a potentially valuable tool to enhance health promotion and patient engagement related to lung cancer screening (LCS). Objective: The aim was to assess the effectiveness of LCS digital awareness campaigns on utilization of low-dose computed tomography (LDCT) and visits to institutional online educational content. Methods: A pay-per-click campaign utilizing Google and Facebook targeted adults aged 55 years and older and caregivers aged 18 years and older (eg, spouses, adult children) with LCS content during a 20-week intervention period from May to September 2016. A concurrent pay-per-click campaign using LinkedIn and Twitter targeted health care providers with LCS content. Geographic target radius was within 60 miles of an academic medical center. Social media data included aggregate demographics and click-through rates (CTRs). Primary outcome measures were visits to institutional Web pages and scheduled LDCT exams. Study period was 20 weeks before, during, and after the digital awareness campaigns. Results: Weekly visits to the institutional LCS Web pages were significantly higher during the digital awareness campaigns compared to the 20-week period prior to implementation (mean 823.9, SD 905.8 vs mean 51, SD 22.3, P=.001). The patient digital awareness campaign surpassed industry standard CTRs on Google (5.85%, 1108/18,955 vs 1.8%) and Facebook (2.59%, 47,750/1,846,070 vs 0.8%). The provider digital awareness campaign surpassed industry standard CTR on LinkedIn (1.1%, 630/57,079 vs 0.3%) but not Twitter (0.19%, 1139/587,133 vs 0.25%). Mean scheduled LDCT exam volumes per week before, during, and after the digital awareness campaigns were 17.4 (SD 7.5), 20.4 (SD 5.4), and 26.2 (SD 6.4), respectively, with the difference between the mean number of scheduled exams after the digital awareness campaigns and the number of exams scheduled before and after the digital awareness campaigns being statistically significant (P<.001). Conclusions: Implementation of the LCS digital awareness campaigns was associated with increased visits to institutional educational Web pages and scheduled LDCT exams. Digital platforms are an important tool to enhance health promotion activities and engagement with patients and providers. UR - http://www.jmir.org/2018/2/e52/ UR - http://dx.doi.org/10.2196/jmir.8932 UR - http://www.ncbi.nlm.nih.gov/pubmed/29449199 ID - info:doi/10.2196/jmir.8932 ER - TY - JOUR AU - Ueda, Nao AU - Yokouchi, Ryoki AU - Onoda, Taro AU - Ogihara, Atsushi PY - 2017/12/19 TI - Characteristics of Articles About Human Papillomavirus Vaccination in Japanese Newspapers: Time-Series Analysis Study JO - JMIR Public Health Surveill SP - e97 VL - 3 IS - 4 KW - papillomavirus vaccines KW - immunization programs KW - uterine cervical neoplasms KW - newspapers as topic KW - mass media KW - data mining KW - Japan N2 - Background: Media coverage and reports have a major influence on individual vaccination and other health-related activities. People use the media to seek information and knowledge on health-related behaviors. They obtain health-related information from media such as television and newspapers, and they trust such information. While several studies have examined the relation between media coverage and individual health, there is a lack of studies that have analyzed media reports of health information. In particular, we have found no analyses related to cervical cancer (human papillomavirus [HPV]) vaccine. Objective: This study aimed to identify mentions of cervical cancer vaccine in Japan?s printed news media and to determine their characteristics. Methods: We used the archival databases of 2 Japanese newspapers, Yomiuri Shimbun (Yomidasu Rekishikan) and Asahi Shimbun (Kikuzo II Visual), for text mining. First, we created a database by extracting articles published between January 1, 2007, and December 31, 2014, that matched the terms ?cervical cancer? AND ?vaccination? in a keyword search. Then, we tallied the extracted articles based on the month of publication and number of characters in order to conduct a time-series analysis. Results: We extracted a total of 219 articles. Of these, 154 (70.3%) were positive and 51 (23.3%) were negative toward HPV vaccination. Of the 51 negative articles, 4 (7.8%) were published before June 2013, when routine vaccination was temporarily discontinued due to concerns regarding side effects, and 47 (92.2%) were published since then. The negative reports commonly cited side effects, although prior to June 2013, these issues were hardly mentioned. Although foreign media reports mentioned side effects before routine vaccination was temporarily discontinued, fewer articles mentioned side effects than recommendations for vaccination. Furthermore, on June 13, 2013, the World Health Organization?s advisory body Global Advisory Committee on Vaccine Safety issued a statement regarding the safety of HPV vaccines, but hardly any articles reported this statement. Rather, several articles were published about the side effects after June 2013. Conclusions: Since we consider media coverage to be a factor affecting human health behavior, the media should extensively report on the cost of not receiving cervical cancer vaccination, global trends concerning cervical cancer vaccination, and statements released by various agencies on the subject. UR - http://publichealth.jmir.org/2017/4/e97/ UR - http://dx.doi.org/10.2196/publichealth.8237 UR - http://www.ncbi.nlm.nih.gov/pubmed/29258972 ID - info:doi/10.2196/publichealth.8237 ER - TY - JOUR AU - Galpin, Adam AU - Meredith, Joanne AU - Ure, Cathy AU - Robinson, Leslie PY - 2017/10/27 TI - ?Thanks for Letting Us All Share Your Mammogram Experience Virtually?: Developing a Web-Based Hub for Breast Cancer Screening JO - JMIR Cancer SP - e17 VL - 3 IS - 2 KW - decision making KW - eHealth KW - cancer screening KW - qualitative research KW - social media KW - mammography N2 - Background: The decision around whether to attend breast cancer screening can often involve making sense of confusing and contradictory information on its risks and benefits. The Word of Mouth Mammogram e-Network (WoMMeN) project was established to create a Web-based resource to support decision making regarding breast cancer screening. This paper presents data from our user-centered approach in engaging stakeholders (both health professionals and service users) in the design of this Web-based resource. Our novel approach involved creating a user design group within Facebook to allow them access to ongoing discussion between researchers, radiographers, and existing and potential service users. Objective: This study had two objectives. The first was to examine the utility of an online user design group for generating insight for the creation of Web-based health resources. We sought to explore the advantages and limitations of this approach. The second objective was to analyze what women want from a Web-based resource for breast cancer screening. Methods: We recruited a user design group on Facebook and conducted a survey within the group, asking questions about design considerations for a Web-based breast cancer screening hub. Although the membership of the Facebook group varied over time, there were 71 members in the Facebook group at the end point of analysis. We next conducted a framework analysis on 70 threads from Facebook and a thematic analysis on the 23 survey responses. We focused additionally on how the themes were discussed by the different stakeholders within the context of the design group. Results: Two major themes were found across both the Facebook discussion and the survey data: (1) the power of information and (2) the hub as a place for communication and support. Information was considered as empowering but also recognized as threatening. Communication and the sharing of experiences were deemed important, but there was also recognition of potential miscommunication within online discussion. Health professionals and service users expressed the same broad concerns, but there were subtle differences in their opinions. Importantly, the themes were triangulated between the Facebook discussions and the survey data, supporting the validity of an online user design group. Conclusions: Online user design groups afford a useful method for understanding stakeholder needs. In contrast to focus groups, they afford access to users from diverse geographical locations and traverse time constraints, allowing more follow-ups to responses. The use of Facebook provides a familiar and naturalistic setting for discussion. Although we acknowledge the limitations in the sample, this approach has allowed us to understand the views of stakeholders in the user-centered design of the WoMMeN hub for breast cancer screening. UR - http://cancer.jmir.org/2017/2/e17/ UR - http://dx.doi.org/10.2196/cancer.8150 UR - http://www.ncbi.nlm.nih.gov/pubmed/29079555 ID - info:doi/10.2196/cancer.8150 ER - TY - JOUR AU - Lenoir, Philippe AU - Moulahi, Bilel AU - Azé, Jérôme AU - Bringay, Sandra AU - Mercier, Gregoire AU - Carbonnel, François PY - 2017/10/16 TI - Raising Awareness About Cervical Cancer Using Twitter: Content Analysis of the 2015 #SmearForSmear Campaign JO - J Med Internet Res SP - e344 VL - 19 IS - 10 KW - uterine cervical neoplasms KW - Papanicolaou test KW - social media KW - early detection of cancer KW - health promotion KW - Twitter N2 - Background: Cervical cancer is the second most common cancer among women under 45 years of age. To deal with the decrease of smear test coverage in the United Kingdom, a Twitter campaign called #SmearForSmear has been launched in 2015 for the European Cervical Cancer Prevention Week. Its aim was to encourage women to take a selfie showing their lipstick going over the edge and post it on Twitter with a raising awareness message promoting cervical cancer screening. The estimated audience was 500 million people. Other public health campaigns have been launched on social media such as Movember to encourage participation and self-engagement. Their result was unsatisfactory as their aim had been diluted to become mainly a social buzz. Objective: The objectives of this study were to identify the tweets delivering a raising awareness message promoting cervical cancer screening (sensitizing tweets) and to understand the characteristics of Twitter users posting about this campaign. Methods: We conducted a 3-step content analysis of the English tweets tagged #SmearForSmear posted on Twitter for the 2015 European Cervical Cancer Prevention Week. Data were collected using the Twitter application programming interface. Their extraction was based on an analysis grid generated by 2 independent researchers using a thematic analysis, validated by a strong Cohen kappa coefficient. A total of 7 themes were coded for sensitizing tweets and 14 for Twitter users? status. Verbatims were thematically and then statistically analyzed. Results: A total of 3019 tweets were collected and 1881 were analyzed. Moreover, 69.96% of tweets had been posted by people living in the United Kingdom. A total of 57.36% of users were women, and sex was unknown in 35.99% of cases. In addition, 54.44% of the users had posted at least one selfie with smeared lipstick. Furthermore, 32.32% of tweets were sensitizing. Independent factors associated with posting sensitizing tweets were women who experienced an abnormal smear test (OR [odds ratio] 13.456, 95% CI 3.101-58.378, P<.001), female gender (OR 3.752, 95% CI 2.133-6.598, P<.001), and people who live in the United Kingdom (OR 2.097, 95% CI 1.447-3.038, P<.001). Nonsensitizing tweets were statistically more posted by a nonhealth or nonmedia company (OR 0.558, 95% CI 0.383-0.814, P<.001). Conclusions: This study demonstrates that the success of a public health campaign using a social media platform depends on its ability to get its targets involved. It also suggests the need to use social marketing to help its dissemination. The clinical impact of this Twitter campaign to increase cervical cancer screening is yet to be evaluated. UR - http://www.jmir.org/2017/10/e344/ UR - http://dx.doi.org/10.2196/jmir.8421 UR - http://www.ncbi.nlm.nih.gov/pubmed/29038096 ID - info:doi/10.2196/jmir.8421 ER - TY - JOUR AU - Mukhija, Dhruvika AU - Venkatraman, Anand AU - Nagpal, Singh Sajan Jiv PY - 2017/08/21 TI - Effectivity of Awareness Months in Increasing Internet Search Activity for Top Malignancies Among Women JO - JMIR Public Health Surveill SP - e55 VL - 3 IS - 3 KW - colorectal cancer, lung cancer, breast cancer, cancer awareness month, infoveillance UR - http://publichealth.jmir.org/2017/3/e55/ UR - http://dx.doi.org/10.2196/publichealth.7714 UR - http://www.ncbi.nlm.nih.gov/pubmed/28827213 ID - info:doi/10.2196/publichealth.7714 ER - TY - JOUR AU - Huesch, Marco AU - Chetlen, Alison AU - Segel, Joel AU - Schetter, Susann PY - 2017/06/09 TI - Frequencies of Private Mentions and Sharing of Mammography and Breast Cancer Terms on Facebook: A Pilot Study JO - J Med Internet Res SP - e201 VL - 19 IS - 6 KW - Facebook KW - online social network KW - social media KW - breast cancer screening KW - mammography KW - user comments KW - websites KW - links N2 - Background: The most popular social networking site in the United States is Facebook, an online forum where circles of friends create, share, and interact with each other?s content in a nonpublic way. Objective: Our objectives were to understand (1) the most commonly used terms and phrases relating to breast cancer screening, (2) the most commonly shared website links that other women interacted with, and (3) the most commonly shared website links, by age groups. Methods: We used a novel proprietary tool from Facebook to analyze all of the more than 1.7 million unique interactions (comments on stories, reshares, and emoji reactions) and stories associated with breast cancer screening keywords that were generated by more than 1.1 million unique female Facebook users over the 1 month between November 15 and December 15, 2016. We report frequency distributions of the most popular shared Web content by age group and keywords. Results: On average, each of 59,000 unique stories during the month was reshared 1.5 times, commented on nearly 8 times, and reacted to more than 20 times by other users. Posted stories were most often authored by women aged 45-54 years. Users shared, reshared, commented on, and reacted to website links predominantly to e-commerce sites (12,200/1.7 million, 36% of all the most popular links), celebrity news (n=8800, 26%), and major advocacy organizations (n=4900, 15%; almost all accounted for by the American Cancer Society breast cancer site). Conclusions: On Facebook, women shared and reacted to links to commercial and informative websites regarding breast cancer and screening. This information could inform patient outreach regarding breast cancer screening, indirectly through better understanding of key issues, and directly through understanding avenues for paid messaging to women authoring and reacting to content in this space. UR - http://www.jmir.org/2017/6/e201/ UR - http://dx.doi.org/10.2196/jmir.7508 UR - http://www.ncbi.nlm.nih.gov/pubmed/28600279 ID - info:doi/10.2196/jmir.7508 ER - TY - JOUR AU - Metwally, Omar AU - Blumberg, Seth AU - Ladabaum, Uri AU - Sinha, R. Sidhartha PY - 2017/06/07 TI - Using Social Media to Characterize Public Sentiment Toward Medical Interventions Commonly Used for Cancer Screening: An Observational Study JO - J Med Internet Res SP - e200 VL - 19 IS - 6 KW - Twitter KW - sentiment analysis KW - cancer screening KW - colonoscopy KW - mammography KW - Pap smear KW - Papanicolaou test KW - social media KW - early detection of cancer N2 - Background: Although cancer screening reduces morbidity and mortality, millions of people worldwide remain unscreened. Social media provide a unique platform to understand public sentiment toward tools that are commonly used for cancer screening. Objective: The objective of our study was to examine public sentiment toward colonoscopy, mammography, and Pap smear and how this sentiment spreads by analyzing discourse on Twitter. Methods: In this observational study, we classified 32,847 tweets (online postings on Twitter) related to colonoscopy, mammography, or Pap smears using a naive Bayes algorithm as containing positive, negative, or neutral sentiment. Additionally, we characterized the spread of sentiment on Twitter using an established model to study contagion. Results: Colonoscopy-related tweets were more likely to express negative than positive sentiment (negative to positive ratio 1.65, 95% CI 1.51-1.80, P<.001), in contrast to the more positive sentiment expressed regarding mammography (negative to positive ratio 0.43, 95% CI 0.39-0.47, P<.001). The proportions of negative versus positive tweets about Pap smear were not significantly different (negative to positive ratio 0.95, 95% CI 0.87-1.04, P=.18). Positive and negative tweets tended to share lexical features across screening modalities. Positive tweets expressed resonance with the benefits of early detection. Fear and pain were the principal lexical features seen in negative tweets. Negative sentiment for colonoscopy and mammography spread more than positive sentiment; no correlation with sentiment and spread was seen for Pap smear. Conclusions: Analysis of social media data provides a unique, quantitative framework to better understand the public?s perception of medical interventions that are commonly used for cancer screening. Given the growing use of social media, public health interventions to improve cancer screening should use the health perceptions of the population as expressed in social network postings about tests that are frequently used for cancer screening, as well as other people they may influence with such postings. UR - http://www.jmir.org/2017/6/e200/ UR - http://dx.doi.org/10.2196/jmir.7485 UR - http://www.ncbi.nlm.nih.gov/pubmed/28592395 ID - info:doi/10.2196/jmir.7485 ER - TY - JOUR AU - Reiter, L. Paul AU - Katz, L. Mira AU - Bauermeister, A. Jose AU - Shoben, B. Abigail AU - Paskett, D. Electra AU - McRee, Annie-Laurie PY - 2017/06/02 TI - Recruiting Young Gay and Bisexual Men for a Human Papillomavirus Vaccination Intervention Through Social Media: The Effects of Advertisement Content JO - JMIR Public Health Surveill SP - e33 VL - 3 IS - 2 KW - HPV KW - HPV vaccine KW - gay and bisexual men KW - social media N2 - Background: Web-based approaches, specifically social media sites, represent a promising approach for recruiting young gay and bisexual men for research studies. Little is known, however, about how the performance of social media advertisements (ads) used to recruit this population is affected by ad content (ie, image and text). Objective: The aim of this study was to evaluate the effects of different images and text included in social media ads used to recruit young gay and bisexual men for the pilot test of a Web-based human papillomavirus (HPV) vaccination intervention. Methods: In July and September 2016, we used paid Facebook advertisements to recruit men who were aged 18-25 years, self-identified as gay or bisexual, US resident, and had not received HPV vaccine. A 4x2x2 factorial experiment varied ad image (a single young adult male, a young adult male couple, a group of young adult men, or a young adult male talking to a doctor), content focus (text mentioning HPV or HPV vaccine), and disease framing (text mentioning cancer or a sexually transmitted disease [STD]). Poisson regression determined whether these experimental factors affected ad performance. Results: The recruitment campaign reached a total of 35,646 users who viewed ads for 36,395 times. This resulted in an overall unique click-through rate of 2.01% (717/35,646) and an overall conversion rate of 0.66% (241/36,395). Reach was higher for ads that included an image of a couple (incidence rate ratio, IRR=4.91, 95% CI 2.68-8.97, P<.001) or a group (IRR=2.65, 95% CI 1.08-6.50, P=.03) compared with those that included an image of a single person. Ads that included an image of a couple also had a higher conversion rate (IRR=2.56, 95% CI 1.13-5.77, P=.02) than ads that included an image of a single person. Ads with text mentioning an STD had a higher unique click-through rate compared with ads with text mentioning cancer (IRR=1.34, 95% CI 1.06-1.69, P=.01). The campaign cost a total of US $413.72 and resulted in 150 eligible and enrolled individuals (US $2.76 per enrolled participant). Conclusions: Facebook ads are a convenient and cost-efficient strategy for reaching and recruiting young gay and bisexual men for a Web-based HPV vaccination intervention. To help optimize ad performance among this population, researchers should consider the importance of the text and image included in the social media recruitment ads. UR - http://publichealth.jmir.org/2017/2/e33/ UR - http://dx.doi.org/10.2196/publichealth.7545 UR - http://www.ncbi.nlm.nih.gov/pubmed/28576758 ID - info:doi/10.2196/publichealth.7545 ER - TY - JOUR AU - Hay, L. Jennifer AU - Berwick, Marianne AU - Zielaskowski, Kate AU - White, AM Kirsten AU - Rodríguez, M. Vivian AU - Robers, Erika AU - Guest, D. Dolores AU - Sussman, Andrew AU - Talamantes, Yvonne AU - Schwartz, R. Matthew AU - Greb, Jennie AU - Bigney, Jessica AU - Kaphingst, A. Kimberly AU - Hunley, Keith AU - Buller, B. David PY - 2017/04/25 TI - Implementing an Internet-Delivered Skin Cancer Genetic Testing Intervention to Improve Sun Protection Behavior in a Diverse Population: Protocol for a Randomized Controlled Trial JO - JMIR Res Protoc SP - e52 VL - 6 IS - 4 KW - genetic testing KW - primary care KW - online health education KW - melanoma prevention KW - skin cancer risk KW - genetic risk communication N2 - Background: Limited translational genomic research currently exists to guide the availability, comprehension, and appropriate use of personalized genomics in diverse general population subgroups. Melanoma skin cancers are preventable, curable, common in the general population, and disproportionately increasing in Hispanics. Objective: Variants in the melanocortin-1 receptor (MC1R) gene are present in approximately 50% of the population, are major factors in determining sun sensitivity, and confer a 2-to-3-fold increase in melanoma risk in the general population, even in populations with darker skin. Therefore, feedback regarding MC1R risk status may raise risk awareness and protective behavior in the general population. Methods: We are conducting a randomized controlled trial examining Internet presentation of the risks and benefits of personalized genomic testing for MC1R gene variants that are associated with increased melanoma risk. We will enroll a total of 885 participants (462 participants are currently enrolled), who will be randomized 6:1 to personalized genomic testing for melanoma risk versus waiting list control. Control participants will be offered testing after outcome assessments. Participants will be balanced across self-reported Hispanic versus non-Hispanic ethnicity (n=750 in personalized genomic testing for melanoma risk arm; n=135 in control arm), and will be recruited from a general population cohort in Albuquerque, New Mexico, which is subject to year-round sun exposure. Baseline surveys will be completed in-person with study staff and follow-up measures will be completed via telephone. Results: Aim 1 of the trial will examine the personal utility of personalized genomic testing for melanoma risk in terms of short-term (3-month) sun protection and skin screening behaviors, family and physician communication, and melanoma threat and control beliefs (ie, putative mediators of behavior change). We will also examine potential unintended consequences of testing among those who receive average-risk personalized genomic testing for melanoma risk findings, and examine predictors of sun protection at 3 months as the outcome. These findings will be used to develop messages for groups that receive average-risk feedback. Aim 2 will compare rates of test consideration in Hispanics versus non-Hispanics, including consideration of testing pros and cons and registration of a decision to either accept or decline testing. Aim 3 will examine personalized genomic testing for melanoma risk feedback comprehension, recall, satisfaction, and cancer-related distress in those who undergo testing, and whether these outcomes differ by ethnicity (Hispanic vs non-Hispanic), or sociocultural or demographic factors. Final outcome data collection is anticipated to be complete by October 2017, at which point data analysis will commence. Conclusions: This study has important implications for personalized genomics in the context of melanoma risk, and may be broadly applicable as a model for delivery of personalized genomic feedback for other health conditions. UR - http://www.researchprotocols.org/2017/4/e52/ UR - http://dx.doi.org/10.2196/resprot.7158 UR - http://www.ncbi.nlm.nih.gov/pubmed/28442450 ID - info:doi/10.2196/resprot.7158 ER - TY - JOUR AU - Gough, Aisling AU - Hunter, F. Ruth AU - Ajao, Oluwaseun AU - Jurek, Anna AU - McKeown, Gary AU - Hong, Jun AU - Barrett, Eimear AU - Ferguson, Marbeth AU - McElwee, Gerry AU - McCarthy, Miriam AU - Kee, Frank PY - 2017/03/23 TI - Tweet for Behavior Change: Using Social Media for the Dissemination of Public Health Messages JO - JMIR Public Health Surveill SP - e14 VL - 3 IS - 1 KW - social media KW - Twitter KW - awareness KW - public heath KW - skin cancer KW - behavior change KW - communication N2 - Background: Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change. Objective: The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media?enabled intervention for skin cancer prevention. Methods: A quasi-experimental feasibility study used social media (Twitter) to disseminate different message ?frames? related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity?s Twitter platform (May 1 to July 14, 2015). Following a 2-week ?washout? period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be ?influencers? in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million). Results: There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4% [95/335] vs postintervention: 39.3% [168/428] answered ?True?) and that melanoma is most serious (49.1% [165/336] vs 55.5% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents ?like to tan? (60.5% [202/334] vs 55.6% [238/428]). Conclusions: Social media?disseminated public health messages reached more than 23% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media. UR - http://publichealth.jmir.org/2017/1/e14/ UR - http://dx.doi.org/10.2196/publichealth.6313 UR - http://www.ncbi.nlm.nih.gov/pubmed/28336503 ID - info:doi/10.2196/publichealth.6313 ER - TY - JOUR AU - Foroughi, Forough AU - Lam, K-Y Alfred AU - Lim, S.C Megan AU - Saremi, Nassim AU - Ahmadvand, Alireza PY - 2016/05/04 TI - ?Googling? for Cancer: An Infodemiological Assessment of Online Search Interests in Australia, Canada, New Zealand, the United Kingdom, and the United States JO - JMIR Cancer SP - e5 VL - 2 IS - 1 KW - cancer KW - neoplasms KW - infodemiology KW - epidemiology KW - geographic mapping KW - Google Trends KW - Internet KW - consumer health information N2 - Background: The infodemiological analysis of queries from search engines to shed light on the status of various noncommunicable diseases has gained increasing popularity in recent years. Objective: The aim of the study was to determine the international perspective on the distribution of information seeking in Google regarding ?cancer? in major English-speaking countries. Methods: We used Google Trends service to assess people?s interest in searching about ?Cancer? classified as ?Disease,? from January 2004 to December 2015 in Australia, Canada, New Zealand, the United Kingdom, and the United States. Then, we evaluated top cities and their relative search volumes (SVs) and country-specific ?Top searches? and ?Rising searches.? We also evaluated the cross-country correlations of SVs for cancer, as well as rank correlations of SVs from 2010 to 2014 with the incidence of cancer in 2012 in the abovementioned countries. Results: From 2004 to 2015, the United States (relative SV [from 100]: 63), Canada (62), and Australia (61) were the top countries searching for cancer in Google, followed by New Zealand (54) and the United Kingdom (48). There was a consistent seasonality pattern in searching for cancer in the United States, Canada, Australia, and New Zealand. Baltimore (United States), St John?s (Canada), Sydney (Australia), Otaika (New Zealand), and Saint Albans (United Kingdom) had the highest search interest in their corresponding countries. ?Breast cancer? was the cancer entity that consistently appeared high in the list of top searches in all 5 countries. The ?Rising searches? were ?pancreatic cancer? in Canada and ?ovarian cancer? in New Zealand. Cross-correlation of SVs was strong between the United States, Canada, and Australia (>.70, P<.01). Conclusions: Cancer maintained its popularity as a search term for people in the United States, Canada, and Australia, comparably higher than New Zealand and the United Kingdom. The increased interest in searching for keywords related to cancer shows the possible effectiveness of awareness campaigns in increasing societal demand for health information on the Web, to be met in community-wide communication or awareness interventions. UR - http://cancer.jmir.org/2016/1/e5/ UR - http://dx.doi.org/10.2196/cancer.5212 UR - http://www.ncbi.nlm.nih.gov/pubmed/28410185 ID - info:doi/10.2196/cancer.5212 ER - TY - JOUR AU - Xu, Songhua AU - Markson, Christopher AU - Costello, L. Kaitlin AU - Xing, Y. Cathleen AU - Demissie, Kitaw AU - Llanos, AM Adana PY - 2016/04/28 TI - Leveraging Social Media to Promote Public Health Knowledge: Example of Cancer Awareness via Twitter JO - JMIR Public Health Surveill SP - e17 VL - 2 IS - 1 KW - awareness KW - breast cancer KW - colorectal cancer KW - disparities KW - lung cancer KW - prostate cancer KW - social media KW - Twitter N2 - Background: As social media becomes increasingly popular online venues for engaging in communication about public health issues, it is important to understand how users promote knowledge and awareness about specific topics. Objective: The aim of this study is to examine the frequency of discussion and differences by race and ethnicity of cancer-related topics among unique users via Twitter. Methods: Tweets were collected from April 1, 2014 through January 21, 2015 using the Twitter public streaming Application Programming Interface (API) to collect 1% of public tweets. Twitter users were classified into racial and ethnic groups using a new text mining approach applied to English-only tweets. Each ethnic group was then analyzed for frequency in cancer-related terms within user timelines, investigated for changes over time and across groups, and measured for statistical significance. Results: Observable usage patterns of the terms "cancer", "breast cancer", "prostate cancer", and "lung cancer" between Caucasian and African American groups were evident across the study period. We observed some variation in the frequency of term usage during months known to be labeled as cancer awareness months, particularly September, October, and November. Interestingly, we found that of the terms studied, "colorectal cancer" received the least Twitter attention. Conclusions: The findings of the study provide evidence that social media can serve as a very powerful and important tool in implementing and disseminating critical prevention, screening, and treatment messages to the community in real-time. The study also introduced and tested a new methodology of identifying race and ethnicity among users of the social media. Study findings highlight the potential benefits of social media as a tool in reducing racial and ethnic disparities. UR - http://publichealth.jmir.org/2016/1/e17/ UR - http://dx.doi.org/10.2196/publichealth.5205 UR - http://www.ncbi.nlm.nih.gov/pubmed/27227152 ID - info:doi/10.2196/publichealth.5205 ER - TY - JOUR AU - Mahoney, Meghan L. AU - Tang, Tang AU - Ji, Kai AU - Ulrich-Schad, Jessica PY - 2015/03/18 TI - The Digital Distribution of Public Health News Surrounding the Human Papillomavirus Vaccination: A Longitudinal Infodemiology Study JO - JMIR Public Health Surveill SP - e2 VL - 1 IS - 1 KW - new media KW - public health dissemination KW - health communication KW - social media KW - HPV vaccination KW - infodemiology KW - infoveillance N2 - Background: New media changes the dissemination of public health information and misinformation. During a guest appearance on the Today Show, US Representative Michele Bachmann claimed that human papillomavirus (HPV) vaccines could cause ?mental retardation?. Objective: The purpose of this study is to explore how new media influences the type of public health information users access, as well as the impact to these platforms after a major controversy. Specifically, this study aims to examine the similarities and differences in the dissemination of news articles related to the HPV vaccination between Google News and Twitter, as well as how the content of news changed after Michele Bachmann?s controversial comment. Methods: This study used a purposive sampling to draw the first 100 news articles that appeared on Google News and the first 100 articles that appeared on Twitter from August 1-October 31, 2011. Article tone, source, topics, concerns, references, publication date, and interactive features were coded. The intercoder reliability had a total agreement of .90. Results: Results indicate that 44.0% of the articles (88/200) about the HPV vaccination had a positive tone, 32.5% (65/200) maintained a neutral tone, while 23.5% (47/200) presented a negative tone. Protection against diseases 82.0% (164/200), vaccine eligibility for females 75.5% (151/200), and side effects 59.0% (118/200) were the top three topics covered by these articles. Google News and Twitter articles significantly differed in article tone, source, topics, concerns covered, types of sources referenced in the article, and uses of interactive features. Most notably, topic focus changed from public health information towards political conversation after Bachmann?s comment. Before the comment, the HPV vaccine news talked more often about vaccine dosing (P<.001), duration (P=.005), vaccine eligibility for females (P=.03), and protection against diseases (P=.04) than did the later pieces. After the controversy, the news topic shifted towards politics (P=.01) and talked more about HPV vaccine eligibility for males (P=.01). Conclusions: This longitudinal infodemiology study suggests that new media influences public health communication, knowledge transaction, and poses potential problems in the amount of misinformation disseminated during public health campaigns. In addition, the study calls for more research to adopt an infodemiology approach to explore relationships between online information supply and public health decisions. UR - http://publichealth.jmir.org/2015/1/e2/ UR - http://dx.doi.org/10.2196/publichealth.3310 UR - http://www.ncbi.nlm.nih.gov/pubmed/27227125 ID - info:doi/10.2196/publichealth.3310 ER - TY - JOUR AU - Nakada, Haruka AU - Yuji, Koichiro AU - Tsubokura, Masaharu AU - Ohsawa, Yukio AU - Kami, Masahiro PY - 2014/05/15 TI - Development of a National Agreement on Human Papillomavirus Vaccination in Japan: An Infodemiology Study JO - J Med Internet Res SP - e129 VL - 16 IS - 5 KW - cervical cancer KW - health policy KW - human papillomavirus KW - public health KW - vaccination N2 - Background: A national agreement on human papillomavirus (HPV) vaccination was achieved relatively quickly in Japan as compared to the United States and India. Objective: The objective was to identify the role of print and online media references, including references to celebrities or other informants, as factors potentially responsible for the relatively rapid national acceptance of HPV vaccination in Japan. Methods: A method of text mining was performed to select keywords, representing the context of the target documents, from articles relevant to the promotion of HPV vaccination appearing in major Japanese newspapers and Web pages between January 2009 and July 2010. The selected keywords were classified as positive, negative, or neutral, and the transition of the frequency of their appearance was analyzed. Results: The number of positive and neutral keywords appearing in newspaper articles increased sharply in early 2010 while the number of negative keywords remained low. The numbers of positive, neutral, and negative keywords appearing in Web pages increased gradually and did not significantly differ by category. Neutral keywords, such as ?vaccine? and ?prevention,? appeared more frequently in newspaper articles, whereas negative keywords, such as ?infertility? and ?side effect,? appeared more frequently in Web pages. The extraction of the positive keyword ?signature campaign? suggests that vaccine beneficiaries cooperated with providers in promoting HPV vaccination. Conclusions: The rapid development of a national agreement regarding HPV vaccination in Japan may be primarily attributed to the advocacy of vaccine beneficiaries, supported by advocacy by celebrities and positive reporting by print and online media. UR - http://www.jmir.org/2014/5/e129/ UR - http://dx.doi.org/10.2196/jmir.2846 UR - http://www.ncbi.nlm.nih.gov/pubmed/24834471 ID - info:doi/10.2196/jmir.2846 ER -