@Article{info:doi/10.2196/publichealth.8944,
author="Wan, Victoria
and McIntyre, Lorraine
and Kent, Debra
and Leong, Dennis
and Henderson, B. Sarah",
title="Near-Real-Time Surveillance of Illnesses Related to Shellfish Consumption in British Columbia: Analysis of Poison Center Data",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="23",
volume="4",
number="1",
pages="e17",
keywords="poison control centers",
keywords="public health surveillance",
keywords="shellfish poisoning",
keywords="norovirus",
keywords="Vibrio parahaemolyticus",
abstract="Background: Data from poison centers have the potential to be valuable for public health surveillance of long-term trends, short-term aberrations from those trends, and poisonings occurring in near-real-time. This information can enable long-term prevention via programs and policies and short-term control via immediate public health response. Over the past decade, there has been an increasing use of poison control data for surveillance in the United States, Europe, and New Zealand, but this resource still remains widely underused. Objective: The British Columbia (BC) Drug and Poison Information Centre (DPIC) is one of five such services in Canada, and it is the only one nested within a public health agency. This study aimed to demonstrate how DPIC data are used for routine public health surveillance in near-real-time using the case study of its alerting system for illness related to consumption of shellfish (ASIRCS). Methods: Every hour, a connection is opened between the WBM software Visual Dotlab Enterprise, which holds the DPIC database, and the R statistical computing environment. This platform is used to extract, clean, and merge all necessary raw data tables into a single data file. ASIRCS automatically and retrospectively scans a 24-hour window within the data file for new cases related to illnesses from shellfish consumption. Detected cases are queried using a list of attributes: the caller location, exposure type, reasons for the exposure, and a list of keywords searched in the clinical notes. The alert generates a report that is tailored to the needs of food safety specialists, who then assess and respond to detected cases. Results: The ASIRCS system alerted on 79 cases between January 2015 and December 2016, and retrospective analysis found 11 cases that were missed. All cases were reviewed by food safety specialists, and 58\% (46/79) were referred to designated regional health authority contacts for follow-up. Of the 42\% (33/79) cases that were not referred to health authorities, some were missing follow-up information, some were triggered by allergies to shellfish, and some were triggered by shellfish-related keywords appearing in the case notes for nonshellfish-related cases. Improvements were made between 2015 and 2016 to reduce the number of cases with missing follow-up information. Conclusions: The surveillance capacity is evident within poison control data as shown from the novel use of DPIC data for identifying illnesses related to shellfish consumption in BC. The further development of surveillance programs could improve and enhance response to public health emergencies related to acute illnesses, chronic diseases, and environmental exposures. ",
doi="10.2196/publichealth.8944",
url="http://publichealth.jmir.org/2018/1/e17/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29475825"
}


@Article{info:doi/10.2196/publichealth.7217,
author="Mejova, Yelena
and Weber, Ingmar
and Fernandez-Luque, Luis",
title="Online Health Monitoring using Facebook Advertisement Audience Estimates in the United States: Evaluation Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="28",
volume="4",
number="1",
pages="e30",
keywords="social media",
keywords="public health",
keywords="Internet",
keywords="infodemiology",
abstract="Background: Facebook, the most popular social network with over one billion daily users, provides rich opportunities for its use in the health domain. Though much of Facebook's data are not available to outsiders, the company provides a tool for estimating the audience of Facebook advertisements, which includes aggregated information on the demographics and interests, such as weight loss or dieting, of Facebook users. This paper explores the potential uses of Facebook ad audience estimates for eHealth by studying the following: (1) for what type of health conditions prevalence estimates can be obtained via social media and (2) what type of marker interests are useful in obtaining such estimates, which can then be used for recruitment within online health interventions. Objective: The objective of this study was to understand the limitations and capabilities of using Facebook ad audience estimates for public health monitoring and as a recruitment tool for eHealth interventions. Methods: We use the Facebook Marketing application programming interface to correlate estimated sizes of audiences having health-related interests with public health data. Using several study cases, we identify both potential benefits and challenges in using this tool. Results: We find several limitations in using Facebook ad audience estimates, for example, using placebo interest estimates to control for background level of user activity on the platform. Some Facebook interests such as plus-size clothing show encouraging levels of correlation (r=.74) across the 50 US states; however, we also sometimes find substantial correlations with the placebo interests such as r=.68 between interest in Technology and Obesity prevalence. Furthermore, we find demographic-specific peculiarities in the interests on health-related topics. Conclusions: Facebook's advertising platform provides aggregate data for more than 190 million US adults. We show how disease-specific marker interests can be used to model prevalence rates in a simple and intuitive manner. However, we also illustrate that building effective marker interests involves some trial-and-error, as many details about Facebook's black box remain opaque. ",
doi="10.2196/publichealth.7217",
url="http://publichealth.jmir.org/2018/1/e30/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29592849"
}


@Article{info:doi/10.2196/publichealth.8950,
author="Lu, Sun Fred
and Hou, Suqin
and Baltrusaitis, Kristin
and Shah, Manan
and Leskovec, Jure
and Sosic, Rok
and Hawkins, Jared
and Brownstein, John
and Conidi, Giuseppe
and Gunn, Julia
and Gray, Josh
and Zink, Anna
and Santillana, Mauricio",
title="Accurate Influenza Monitoring and Forecasting Using Novel Internet Data Streams: A Case Study in the Boston Metropolis",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="09",
volume="4",
number="1",
pages="e4",
keywords="epidemiology",
keywords="public health",
keywords="machine learning",
keywords="regression analysis",
keywords="influenza, human",
keywords="communicable diseases",
keywords="statistics",
keywords="patient generated data",
abstract="Background: Influenza outbreaks pose major challenges to public health around the world, leading to thousands of deaths a year in the United States alone. Accurate systems that track influenza activity at the city level are necessary to provide actionable information that can be used for clinical, hospital, and community outbreak preparation. Objective: Although Internet-based real-time data sources such as Google searches and tweets have been successfully used to produce influenza activity estimates ahead of traditional health care--based systems at national and state levels, influenza tracking and forecasting at finer spatial resolutions, such as the city level, remain an open question. Our study aimed to present a precise, near real-time methodology capable of producing influenza estimates ahead of those collected and published by the Boston Public Health Commission (BPHC) for the Boston metropolitan area. This approach has great potential to be extended to other cities with access to similar data sources. Methods: We first tested the ability of Google searches, Twitter posts, electronic health records, and a crowd-sourced influenza reporting system to detect influenza activity in the Boston metropolis separately. We then adapted a multivariate dynamic regression method named ARGO (autoregression with general online information), designed for tracking influenza at the national level, and showed that it effectively uses the above data sources to monitor and forecast influenza at the city level 1 week ahead of the current date. Finally, we presented an ensemble-based approach capable of combining information from models based on multiple data sources to more robustly nowcast as well as forecast influenza activity in the Boston metropolitan area. The performances of our models were evaluated in an out-of-sample fashion over 4 influenza seasons within 2012-2016, as well as a holdout validation period from 2016 to 2017. Results: Our ensemble-based methods incorporating information from diverse models based on multiple data sources, including ARGO, produced the most robust and accurate results. The observed Pearson correlations between our out-of-sample flu activity estimates and those historically reported by the BPHC were 0.98 in nowcasting influenza and 0.94 in forecasting influenza 1 week ahead of the current date. Conclusions: We show that information from Internet-based data sources, when combined using an informed, robust methodology, can be effectively used as early indicators of influenza activity at fine geographic resolutions. ",
doi="10.2196/publichealth.8950",
url="http://publichealth.jmir.org/2018/1/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29317382"
}


@Article{info:doi/10.2196/publichealth.7444,
author="Liu, Sam
and Zhu, Miaoqi
and Young, D. Sean",
title="Monitoring Freshman College Experience Through Content Analysis of Tweets: Observational Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="11",
volume="4",
number="1",
pages="e5",
keywords="social networking",
keywords="big data",
keywords="population surveillance",
keywords="education",
keywords="students",
keywords="social media",
keywords="Twitter",
abstract="Background: Freshman experiences can greatly influence students' success. Traditional methods of monitoring the freshman experience, such as conducting surveys, can be resource intensive and time consuming. Social media, such as Twitter, enable users to share their daily experiences. Thus, it may be possible to use Twitter to monitor students' postsecondary experience. Objective: Our objectives were to (1) describe the proportion of content posted on Twitter by college students relating to academic studies, personal health, and social life throughout the semester; and (2) examine whether the proportion of content differed by demographics and during nonexam versus exam periods. Methods: Between October 5 and December 11, 2015, we collected tweets from 170 freshmen attending the University of California Los Angeles, California, USA, aged 18 to 20 years. We categorized the tweets into topics related to academic, personal health, and social life using keyword searches. Mann-Whitney U and Kruskal-Wallis H tests examined whether the content posted differed by sex, ethnicity, and major. The Friedman test determined whether the total number of tweets and percentage of tweets related to academic studies, personal health, and social life differed between nonexam (weeks 1-8) and final exam (weeks 9 and 10) periods. Results: Participants posted 24,421 tweets during the fall semester. Academic-related tweets (n=3433, 14.06\%) were the most prevalent during the entire semester, compared with tweets related to personal health (n=2483, 10.17\%) and social life (n=1646, 6.74\%). The proportion of academic-related tweets increased during final-exam compared with nonexam periods (mean rank 68.9, mean 18\%, standard error (SE) 0.1\% vs mean rank 80.7, mean 21\%, SE 0.2\%; Z=--2.1, P=.04). Meanwhile, the proportion of tweets related to social life decreased during final exams compared with nonexam periods (mean rank 70.2, mean 5.4\%, SE 0.01\% vs mean rank 81.8, mean 7.4\%, SE 0.01\%; Z=--4.8, P<.001). Women tweeted more often than men during both nonexam (mean rank 95.8 vs 76.8; U=2876, P=.02) and final-exam periods (mean rank 96.2 vs 76.2; U=2832, P=.01). The percentages of academic-related tweets were similar between ethnic groups during nonexam periods (P>.05). However, during the final-exam periods, the percentage of academic tweets was significantly lower among African Americans than whites ($\chi$24=15.1, P=.004). The percentages of tweets related to academic studies, personal health, and social life were not significantly different between areas of study during nonexam and exam periods (P>.05). Conclusions: The results suggest that the number of tweets related to academic studies and social life fluctuates to reflect real-time events. Student's ethnicity influenced the proportion of academic-related tweets posted. The findings from this study provide valuable information on the types of information that could be extracted from social media data. This information can be valuable for school administrators and researchers to improve students' university experience. ",
doi="10.2196/publichealth.7444",
url="http://publichealth.jmir.org/2018/1/e5/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29326096"
}


@Article{info:doi/10.2196/publichealth.8186,
author="Farhadloo, Mohsen
and Winneg, Kenneth
and Chan, Sally Man-Pui
and Hall Jamieson, Kathleen
and Albarracin, Dolores",
title="Associations of Topics of Discussion on Twitter With Survey Measures of Attitudes, Knowledge, and Behaviors Related to Zika: Probabilistic Study in the United States",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="09",
volume="4",
number="1",
pages="e16",
keywords="Zika",
keywords="Twitter",
keywords="topic modeling",
keywords="public policy",
keywords="public health",
abstract="Background: Recent outbreaks of Zika virus around the world led to increased discussions about this issue on social media platforms such as Twitter. These discussions may provide useful information about attitudes, knowledge, and behaviors of the population regarding issues that are important for public policy. Objective: We sought to identify the associations of the topics of discussions on Twitter and survey measures of Zika-related attitudes, knowledge, and behaviors, not solely based upon the volume of such discussions but by analyzing the content of conversations using probabilistic techniques. Methods: Using probabilistic topic modeling with US county and week as the unit of analysis, we analyzed the content of Twitter online communications to identify topics related to the reported attitudes, knowledge, and behaviors captured in a national representative survey (N=33,193) of the US adult population over 33 weeks. Results: Our analyses revealed topics related to ``congress funding for Zika,'' ``microcephaly,'' ``Zika-related travel discussions,'' ``insect repellent,'' ``blood transfusion technology,'' and ``Zika in Miami'' were associated with our survey measures of attitudes, knowledge, and behaviors observed over the period of the study. Conclusions: Our results demonstrated that it is possible to uncover topics of discussions from Twitter communications that are associated with the Zika-related attitudes, knowledge, and behaviors of populations over time. Social media data can be used as a complementary source of information alongside traditional data sources to gauge the patterns of attitudes, knowledge, and behaviors in a population. ",
doi="10.2196/publichealth.8186",
url="http://publichealth.jmir.org/2018/1/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29426815"
}


@Article{info:doi/10.2196/publichealth.8726,
author="Mavragani, Amaryllis
and Sampri, Alexia
and Sypsa, Karla
and Tsagarakis, P. Konstantinos",
title="Integrating Smart Health in the US Health Care System: Infodemiology Study of Asthma Monitoring in the Google Era",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="12",
volume="4",
number="1",
pages="e24",
keywords="asthma",
keywords="big data",
keywords="forecasting",
keywords="Google trends",
keywords="health care",
keywords="health informatics",
keywords="internet behavior",
keywords="nowcasting",
keywords="online behavior",
keywords="smart health",
abstract="Background: With the internet's penetration and use constantly expanding, this vast amount of information can be employed in order to better assess issues in the US health care system. Google Trends, a popular tool in big data analytics, has been widely used in the past to examine interest in various medical and health-related topics and has shown great potential in forecastings, predictions, and nowcastings. As empirical relationships between online queries and human behavior have been shown to exist, a new opportunity to explore the behavior toward asthma---a common respiratory disease---is present. Objective: This study aimed at forecasting the online behavior toward asthma and examined the correlations between queries and reported cases in order to explore the possibility of nowcasting asthma prevalence in the United States using online search traffic data. Methods: Applying Holt-Winters exponential smoothing to Google Trends time series from 2004 to 2015 for the term ``asthma,'' forecasts for online queries at state and national levels are estimated from 2016 to 2020 and validated against available Google query data from January 2016 to June 2017. Correlations among yearly Google queries and between Google queries and reported asthma cases are examined. Results: Our analysis shows that search queries exhibit seasonality within each year and the relationships between each 2 years' queries are statistically significant (P<.05). Estimated forecasting models for a 5-year period (2016 through 2020) for Google queries are robust and validated against available data from January 2016 to June 2017. Significant correlations were found between (1) online queries and National Health Interview Survey lifetime asthma (r=--.82, P=.001) and current asthma (r=--.77, P=.004) rates from 2004 to 2015 and (2) between online queries and Behavioral Risk Factor Surveillance System lifetime (r=--.78, P=.003) and current asthma (r=--.79, P=.002) rates from 2004 to 2014. The correlations are negative, but lag analysis to identify the period of response cannot be employed until short-interval data on asthma prevalence are made available. Conclusions: Online behavior toward asthma can be accurately predicted, and significant correlations between online queries and reported cases exist. This method of forecasting Google queries can be used by health care officials to nowcast asthma prevalence by city, state, or nationally, subject to future availability of daily, weekly, or monthly data on reported cases. This method could therefore be used for improved monitoring and assessment of the needs surrounding the current population of patients with asthma. ",
doi="10.2196/publichealth.8726",
url="http://publichealth.jmir.org/2018/1/e24/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29530839"
}


@Article{info:doi/10.2196/publichealth.7598,
author="Yagahara, Ayako
and Hanai, Keiri
and Hasegawa, Shin
and Ogasawara, Katsuhiko",
title="Relationships Among Tweets Related to Radiation: Visualization Using Co-Occurring Networks",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="15",
volume="4",
number="1",
pages="e26",
keywords="Twitter",
keywords="social media",
keywords="public concern",
keywords="nuclear power plants",
keywords="morphological analysis",
keywords="network analysis",
keywords="radiation",
abstract="Background: After the Fukushima Daiichi nuclear accident on March 11, 2011, interest in, and fear of, radiation increased among citizens. When such accidents occur, appropriate risk communication must provided by the government. It is therefore necessary to understand the fears of citizens in the days after such accidents. Objective: This study aimed to identify the progression of people's concerns, specifically fear, from a study of radiation-related tweets in the days after the Fukushima Daiichi nuclear accident. Methods: From approximately 1.5 million tweets in Japanese including any of the phrases ``radiation'' (???), ``radioactivity'' (???), and ``radioactive substance'' (?????) sent March 11-17, 2011, we extracted tweets that expressed fear. We then performed a morphological analysis on the extracted tweets. Citizens' fears were visualized by creating co-occurrence networks using co-occurrence degrees showing relationship strength. Moreover, we calculated the Jaccard coefficient, which is one of the co-occurrence indices for expressing the strength of the relationship between morphemes when creating networks. Results: From the visualization of the co-occurrence networks, we found high citizen interest in ``nuclear power plant'' on March 11 and 12, ``health'' on March 12 and 13, ``medium'' on March 13 and 14, and ``economy'' on March 15. On March 16 and 17, citizens' interest changed to ``lack of goods in the afflicted area.'' In each co-occurrence network, trending topics, citizens' fears, and opinions to the government were extracted. Conclusions: This study used Twitter to understand changes in the concerns of Japanese citizens during the week after the Fukushima Daiichi nuclear accident, with a focus specifically on citizens' fears. We found that immediately after the accident, the interest in the accident itself was high, and then interest shifted to concerns affecting life, such as health and economy, as the week progressed. Clarifying citizens' fears and the dissemination of information through mass media and social media can add to improved risk communication in the future. ",
doi="10.2196/publichealth.7598",
url="http://publichealth.jmir.org/2018/1/e26/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29549069"
}


@Article{info:doi/10.2196/publichealth.8144,
author="Cherian, Roy
and Westbrook, Marisa
and Ramo, Danielle
and Sarkar, Urmimala",
title="Representations of Codeine Misuse on Instagram: Content Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="20",
volume="4",
number="1",
pages="e22",
keywords="prescription opioid misuse",
keywords="social media",
keywords="poly-substance use",
keywords="Instagram",
abstract="Background: Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). Objective: The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. Methods: We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. Results: A majority of images (50/100; 50.0\%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. Conclusions: The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. ",
doi="10.2196/publichealth.8144",
url="http://publichealth.jmir.org/2018/1/e22/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29559422"
}


@Article{info:doi/10.2196/publichealth.8198,
author="Chen, Bin
and Shao, Jian
and Liu, Kui
and Cai, Gaofeng
and Jiang, Zhenggang
and Huang, Yuru
and Gu, Hua
and Jiang, Jianmin",
title="Does Eating Chicken Feet With Pickled Peppers Cause Avian Influenza? Observational Case Study on Chinese Social Media During the Avian Influenza A (H7N9) Outbreak",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="29",
volume="4",
number="1",
pages="e32",
keywords="social media",
keywords="misinformation",
keywords="infodemiology",
keywords="avian influenza A",
keywords="disease outbreak",
abstract="Background: A hot topic on the relationship between a popular avian-origin food and avian influenza occurred on social media during the outbreak of the emerging avian influenza A (H7N9). The misinformation generated from this topic had caused great confusion and public concern. Objective: Our goals were to analyze the trend and contents of the relevant posts during the outbreak. We also aimed to understand the characteristics of the misinformation and to provide suggestions to reduce public misconception on social media during the emerging disease outbreak. Methods: The original microblog posts were collected from China's Sina Weibo and Tencent Weibo using a combination of keywords between April 1, 2013 and June 2, 2013. We analyzed the weekly and daily trend of the relevant posts. Content analyses were applied to categorize the posts into 4 types with unified sorting criteria. The posts' characteristics and geographic locations were also analyzed in each category. We conducted further analysis on the top 5 most popular misleading posts. Results: A total of 1680 original microblog posts on the topic were retrieved and 341 (20.30\%) of these posts were categorized as misleading messages. The number of relevant posts had not increased much during the first 2 weeks but rose to a high level in the next 2 weeks after the sudden increase in number of reported cases at the beginning of week 3. The posts under ``misleading messages'' occurred and increased from the beginning of week 3, but their daily posting number decreased when the daily number of posts under ``refuting messages'' outnumbered them. The microbloggers of the misleading posts had the lowest mean rank of followers and previous posts, but their posts had a highest mean rank of posts. The proportion of ``misleading messages'' in places with no reported cases was significantly higher than that in the epidemic areas (23.6\% vs 13.8\%). The popular misleading posts appeared to be short and consisted of personal narratives, which were easily disseminated on social media. Conclusions: Our findings suggested the importance of responding to common questions and misconceptions on social media platforms from the beginning of disease outbreaks. Authorities need to release clear and reliable information related to the popular topics early on. The microbloggers posting correct information should be empowered and their posts could be promoted to clarify false information. Equal importance should be attached to clarify misinformation in both the outbreak and nonoutbreak areas. ",
doi="10.2196/publichealth.8198",
url="http://publichealth.jmir.org/2018/1/e32/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29599109"
}


@Article{info:doi/10.2196/publichealth.7823,
author="Sinha, S. Michael
and Freifeld, C. Clark
and Brownstein, S. John
and Donneyong, M. Macarius
and Rausch, Paula
and Lappin, M. Brian
and Zhou, H. Esther
and Dal Pan, J. Gerald
and Pawar, M. Ajinkya
and Hwang, J. Thomas
and Avorn, Jerry
and Kesselheim, S. Aaron",
title="Social Media Impact of the Food and Drug Administration's Drug Safety Communication Messaging About Zolpidem: Mixed-Methods Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="05",
volume="4",
number="1",
pages="e1",
keywords="Food and Drug Administration",
keywords="drug safety communications",
keywords="surveillance",
keywords="epidemiology",
keywords="social media",
keywords="Twitter",
keywords="Facebook",
keywords="Google Trends",
abstract="Background: The Food and Drug Administration (FDA) issues drug safety communications (DSCs) to health care professionals, patients, and the public when safety issues emerge related to FDA-approved drug products. These safety messages are disseminated through social media to ensure broad uptake. Objective: The objective of this study was to assess the social media dissemination of 2 DSCs released in 2013 for the sleep aid zolpidem. Methods: We used the MedWatcher Social program and the DataSift historic query tool to aggregate Twitter and Facebook posts from October 1, 2012 through August 31, 2013, a period beginning approximately 3 months before the first DSC and ending 3 months after the second. Posts were categorized as (1) junk, (2) mention, and (3) adverse event (AE) based on a score between --0.2 (completely unrelated) to 1 (perfectly related). We also looked at Google Trends data and Wikipedia edits for the same time period. Google Trends search volume is scaled on a range of 0 to 100 and includes ``Related queries'' during the relevant time periods. An interrupted time series (ITS) analysis assessed the impact of DSCs on the counts of posts with specific mention of zolpidem-containing products. Chow tests for known structural breaks were conducted on data from Twitter, Facebook, and Google Trends. Finally, Wikipedia edits were pulled from the website's editorial history, which lists all revisions to a given page and the editor's identity. Results: In total, 174,286 Twitter posts and 59,641 Facebook posts met entry criteria. Of those, 16.63\% (28,989/174,286) of Twitter posts and 25.91\% (15,453/59,641) of Facebook posts were labeled as junk and excluded. AEs and mentions represented 9.21\% (16,051/174,286) and 74.16\% (129,246/174,286) of Twitter posts and 5.11\% (3,050/59,641) and 68.98\% (41,138/59,641) of Facebook posts, respectively. Total daily counts of posts about zolpidem-containing products increased on Twitter and Facebook on the day of the first DSC; Google searches increased on the week of the first DSC. ITS analyses demonstrated variability but pointed to an increase in interest around the first DSC. Chow tests were significant (P<.0001) for both DSCs on Facebook and Twitter, but only the first DSC on Google Trends. Wikipedia edits occurred soon after each DSC release, citing news articles rather than the DSC itself and presenting content that needed subsequent revisions for accuracy. Conclusions: Social media offers challenges and opportunities for dissemination of the DSC messages. The FDA could consider strategies for more actively disseminating DSC safety information through social media platforms, particularly when announcements require updating. The FDA may also benefit from directly contributing content to websites like Wikipedia that are frequently accessed for drug-related information. ",
doi="10.2196/publichealth.7823",
url="http://publichealth.jmir.org/2018/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29305342"
}


@Article{info:doi/10.2196/publichealth.6260,
author="Brown-Johnson, G. Cati
and Boeckman, M. Lindsay
and White, H. Ashley
and Burbank, D. Andrea
and Paulson, Sjonna
and Beebe, A. Laura",
title="Trust in Health Information Sources: Survey Analysis of Variation by Sociodemographic and Tobacco Use Status in Oklahoma",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="12",
volume="4",
number="1",
pages="e8",
keywords="tobacco use cessation",
keywords="health communication",
keywords="trust",
keywords="social media",
keywords="health care providers",
keywords="electronic cigarettes",
keywords="mass media",
keywords="radio",
keywords="television",
keywords="Oklahoma",
abstract="Background: Modern technology (ie, websites and social media) has significantly changed social mores in health information access and delivery. Although mass media campaigns for health intervention have proven effective and cost-effective in changing health behavior at a population scale, this is best studied in traditional media sources (ie, radio and television). Digital health interventions are options that use short message service/text messaging, social media, and internet technology. Although exposure to these products is becoming ubiquitous, electronic health information is novel, incompletely disseminated, and frequently inaccurate, which decreases public trust. Previous research has shown that audience trust in health care providers significantly moderates health outcomes, demographics significantly influence audience trust in electronic media, and preexisting health behaviors such as smoking status significantly moderate audience receptivity to traditional mass media. Therefore, modern health educators must assess audience trust in all sources, both media (traditional and digital) and interpersonal, to balance pros and cons before structuring multicomponent community health interventions. Objective: We aimed to explore current trust and moderators of trust in health information sources given recent changes in digital health information access and delivery to inform design of future health interventions in Oklahoma. Methods: We conducted phone surveys of a cross-sectional sample of 1001 Oklahoma adults (age 18-65 years) in spring 2015 to assess trust in seven media sources: traditional (television and radio), electronic (online and social media), and interpersonal (providers, insurers, and family/friends). We also gathered information on known moderators of trust (sociodemographics and tobacco use status). We modeled log odds of a participant rating a source as ``trustworthy'' (SAS PROC SURVEYLOGISTIC), with subanalysis for confounders (sociodemographics and tobacco use). Results: Oklahomans showed the highest trust in interpersonal sources: 81\% (808/994) reported providers were trustworthy, 55\% (550/999) for friends and family, and 48\% (485/998) for health insurers. For media sources, 24\% of participants (232/989) rated the internet as trustworthy, followed by 21\% of participants for television (225/998), 18\% for radio (199/988), and only 11\% for social media (110/991). Despite this low self-reported trust in social media, 40\% (406/991) of participants reported using social media for tobacco-related health information. Trust in health providers did not vary by subpopulation, but sociodemographic variables (gender, income, and education) and tobacco use status significantly moderated trust in other sources. Women were on the whole more trusting than men, trust in media decreased with income, and trust in friends and family decreased with education. Conclusions: Health education interventions should incorporate digital media, particularly when targeting low-income populations. Utilizing health care providers in social media settings could leverage high-trust and low-cost features of providers and social media, respectively. ",
doi="10.2196/publichealth.6260",
url="http://publichealth.jmir.org/2018/1/e8/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29434015"
}


@Article{info:doi/10.2196/publichealth.7998,
author="Zhou, Jiaqi
and Zhang, Qingpeng
and Zeng, Dajun Daniel
and Tsui, Leung Kwok",
title="Influence of Flavors on the Propagation of E-Cigarette--Related Information: Social Media Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="23",
volume="4",
number="1",
pages="e27",
keywords="e-cigarettes",
keywords="flavors",
keywords="social media",
keywords="information propagation",
keywords="social networks",
keywords="electronic nicotine delivery systems",
keywords="flavoring agents",
keywords="information dissemination",
keywords="social networking",
abstract="Background: Modeling the influence of e-cigarette flavors on information propagation could provide quantitative policy decision support concerning smoking initiation and contagion, as well as e-cigarette regulations. Objective: The objective of this study was to characterize the influence of flavors on e-cigarette--related information propagation on social media. Methods: We collected a comprehensive dataset of e-cigarette--related discussions from public Pages on Facebook. We identified 11 categories of flavors based on commonly used categorizations. Each post's frequency of being shared served as a proxy measure of information propagation. We evaluated a set of regression models and chose the hurdle negative binomial model to characterize the influence of different flavors and nonflavor control variables on e-cigarette--related information propagation. Results: We found that 5 flavors (sweet, dessert \& bakery, fruits, herbs \& spices, and tobacco) had significantly negative influences on e-cigarette--related information propagation, indicating the users' tendency not to share posts related to these flavors. We did not find a positive significance of any flavors, which is contradictory to previous research. In addition, we found that a set of nonflavor--related factors were associated with information propagation. Conclusions: Mentions of flavors in posts did not enhance the popularity of e-cigarette--related information. Certain flavors could even have reduced the popularity of information, indicating users' lack of interest in flavors. Promoting e-cigarette--related information with mention of flavors is not an effective marketing approach. This study implies the potential concern of users about flavorings and suggests a need to regulate the use of flavorings in e-cigarettes. ",
doi="10.2196/publichealth.7998",
url="http://publichealth.jmir.org/2018/1/e27/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29572202"
}


@Article{info:doi/10.2196/publichealth.8997,
author="Torres, Silva Thiago
and De Boni, Brandini Raquel
and de Vasconcellos, TL Mauricio
and Luz, Mendes Paula
and Hoagland, Brenda
and Moreira, Ismerio Ronaldo
and Veloso, Gon{\c{c}}alves Valdilea
and Grinsztejn, Beatriz",
title="Awareness of Prevention Strategies and Willingness to Use Preexposure Prophylaxis in Brazilian Men Who Have Sex With Men Using Apps for Sexual Encounters: Online Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="22",
volume="4",
number="1",
pages="e11",
keywords="HIV",
keywords="prevention",
keywords="MSM",
keywords="app",
keywords="internet",
keywords="PrEP",
keywords="Brazil",
keywords="Latin America",
abstract="Background: Geosocial networking (GSN) smartphone apps are becoming the main venue for sexual encounters among Brazilian men who have sex with men (MSM). To address the increased HIV incidence in this population, preexposure prophylaxis (PrEP) was recently implemented in the Brazilian public health system in the context of combined HIV prevention. Objective: This study aimed to describe the characteristics of MSM using GSN apps for sexual encounters, their awareness of prevention strategies, and willingness to use PrEP. Methods: This study was an online cross-sectional study conducted in 10 Brazilian state capitals from July 1 to July 31, 2016. The questionnaire was programmed on SurveyGizmo and advertised in two GSN apps used by MSM to find sexual partners (Hornet and Grindr). Inclusion criteria were >18 years of age, cisgender men, with an HIV-negative status. Eligible individuals answered questions on: demographics; behavior; and knowledge, preferences, and willingness to use PrEP, nonoccupational postexposure prophylaxis (nPEP), HIV self-testing (HIVST), and condoms. Logistic regression modeling was performed to assess the factors associated with daily oral PrEP willingness. Results: During the study period, 8885 individuals provided consent and started the questionnaire. Of these, 23.05\% (2048/8885) were ineligible, 6837 (6837/8885, 76.94\%) initiated, and 5065 (5065/8885, 57.00\%) completed the entire questionnaire and were included in the present analysis. Median age was 30 years (interquartile range: 25-36), most self-declared as MSM (4991/5065, 98.54\%), white (3194/5065, 63.06\%), middle income (2148/5065, 42.41\%), and had 12 or more years of schooling (3106/5062, 61.36\%). The majority of MSM (3363/5064, 66.41\%) scored >10 points (high risk) on The HIV Incidence Risk for MSM Scale, but only 21.39\% (1083/5064) had a low perceived likelihood of getting HIV in the next year. Daily use of apps for sex was reported by 35.58\% (1798/5054). Most MSM (4327/5065, 85.43\%) reported testing for HIV at least once in their lifetime and 9.16\% (464/5065) used nPEP in the previous year. PrEP, nPEP, and HIVST awareness was reported by 57.89\% (2932/5065), 57.39\% (2907/5065), and 26.57\% (1346/5065) of participants, respectively. Half of all respondents (2653/5065, 52.38\%) were willing to use daily oral PrEP, and this finding was associated with higher numbers of male sexual partners (adjusted odds ratio [AOR] 1.26, 95\% CI 1.09-1.47), condomless receptive anal intercourse (AOR 1.27, 95\% CI 1.12-1.44), sex with HIV-positive partner versus no HIV-positive partner (one HIV-positive partner: AOR 1.36, 95\% CI 1.11-1.67), daily use of apps for sexual encounters (AOR 1.48, 95\% CI 1.17-1.87), high and unknown perceived likelihood of getting HIV in the next year (AOR 1.72, 95\% CI 1.47-2.02 and AOR 1.39, 95\% CI 1.13-1.70), sexually transmitted infection diagnosis (AOR 1.25, 95\% CI 1.03-1.51), stimulant use (AOR 1.24, 95\% CI 1.07-1.43), PrEP awareness (AOR 1.48, 95\% CI 1.30-1.70), and unwillingness to use condoms (AOR 1.16, 95\% CI 1.00-1.33). Conclusions: Our results evidenced high-risk scores in the studied population, suggesting the importance of PrEP use. Those individuals presenting risky sexual behaviors were more willing to use PrEP. Nonetheless, only 58\% (2932/5065) of individuals had heard about this prevention strategy. Efforts to increase awareness of new prevention strategies are needed, and mobile health tools are a promising strategy to reach MSM. ",
doi="10.2196/publichealth.8997",
url="http://publichealth.jmir.org/2018/1/e11/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29358160"
}


@Article{info:doi/10.2196/publichealth.8089,
author="Kahle, M. Erin
and Sullivan, Stephen
and Stephenson, Rob",
title="Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="23",
volume="4",
number="1",
pages="e13",
keywords="human immunodeficiency virus",
keywords="pre-exposure prophylaxis (PrEP)",
keywords="men who have sex with men",
abstract="Background: Awareness of pre-exposure prophylaxis (PrEP) for HIV prevention is increasing, but little is known about the functional knowledge of PrEP and its impact on willingness to use PrEP. Objective: The objective of this study was to assess the functional knowledge of PrEP among a sample of gay, bisexual, and other men who have sex with men (MSM) participating in a Web-based survey of sexually active MSM. Methods: Men at least 18 years old, residing in the United States, and reporting sex with a man in the previous 6 months were recruited through social networking websites. PrEP functional knowledge included the following 4 questions (1) efficacy of consistent PrEP use, (2) inconsistent PrEP use and effectiveness, (3) PrEP and condom use, and (4) effectiveness at reducing sexually transmitted infections (STIs). Ordinal logistic regression was used to identify respondent characteristics associated with PrEP functional knowledge. In a subsample of participants responding to HIV prevention questions, we compared willingness to use PrEP by response to PrEP functional knowledge using logistic regression analysis adjusted for age, race and ethnicity, and education level. Results: Among 573 respondents, PrEP knowledge was high regarding adherence (488/573, 85.2\%), condom use (532/573, 92.8\%), and STIs (480/573, 83.8\%), but only 252/573 (44.0\%) identified the correct efficacy. Lower functional PrEP knowledge was associated with minority race/ethnicity (P=.005), lower education (P=.01), and not having an HIV test in the past year (P=.02). Higher PrEP knowledge was associated with willingness to use PrEP (P=.009). Younger age was not associated with higher PrEP functional knowledge or willingness to use PrEP. Conclusions: PrEP knowledge was generally high in our study, including condom use and consistent use but may be lacking in higher risk MSM. The majority of respondents did not correctly identify PrEP efficacy with consistent use, which could impact motivation to seek out PrEP for HIV prevention. Targeted messaging to increase PrEP knowledge may increase PrEP use. ",
doi="10.2196/publichealth.8089",
url="http://publichealth.jmir.org/2018/1/e13/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29362213"
}


@Article{info:doi/10.2196/publichealth.7733,
author="Kecojevic, Aleksandar
and Basch, Corey
and Basch, Charles
and Kernan, William",
title="Pre-Exposure Prophylaxis YouTube Videos: Content Evaluation",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="16",
volume="4",
number="1",
pages="e19",
keywords="YouTube",
keywords="pre-exposure prophylaxis (PrEP)",
keywords="Truvada",
keywords="video content.",
abstract="Background: Antiretroviral (ARV) medicines reduce the risk of transmitting the HIV virus and are recommended as daily pre-exposure prophylaxis (PrEP) in combination with safer sex practices for HIV-negative individuals at a high risk for infection, but are underused in HIV prevention. Previous literature suggests that YouTube is extensively used to share health information. While pre-exposure prophylaxis (PrEP) is a novel and promising approach to HIV prevention, there is limited understanding of YouTube videos as a source of information on PrEP. Objective: The objective of this study was to describe the sources, characteristics, and content of the most widely viewed PrEP YouTube videos published up to October 1, 2016. Methods: The keywords ``pre-exposure prophylaxis'' and ``Truvada'' were used to find 217 videos with a view count >100. Videos were coded for source, view count, length, number of comments, and selected aspects of content. Videos were also assessed for the most likely target audience. Results: The total cumulative number of views was >2.3 million, however, a single Centers for Disease Control and Prevention video accounted for >1.2 million of the total cumulative views. A great majority (181/217, 83.4\%) of the videos promoted the use of PrEP, whereas 60.8\% (132/217) identified the specific target audience. In contrast, only 35.9\% (78/217) of the videos mentioned how to obtain PrEP, whereas less than one third addressed the costs, side effects, and safety aspects relating to PrEP. Medical and academic institutions were the sources of the largest number of videos (66/217, 30.4\%), followed by consumers (63/217, 29.0\%), community-based organizations (CBO; 48/217, 22.1\%), and media (40/217, 18.4\%). Videos uploaded by the media sources were more likely to discuss the cost of PrEP (P<.001), whereas the use of PrEP was less likely to be promoted in videos uploaded by individual consumers (P=.002) and more likely to be promoted in videos originated by CBOs (P=.009). The most common target audience for the videos was gay and bisexual men. Conclusions: YouTube videos can be used to share reliable PrEP information with individuals. Further research is needed to identify the best practices for using this medium to promote and increase PrEP uptake. ",
doi="10.2196/publichealth.7733",
url="http://publichealth.jmir.org/2018/1/e19/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29467119"
}


@Article{info:doi/10.2196/publichealth.8159,
author="Lindsay, Cristina Ana
and Wasserman, Minerva
and Mu{\~n}oz, A. Mario
and Wallington, F. Sherrie
and Greaney, L. Mary",
title="Examining Influences of Parenting Styles and Practices on Physical Activity and Sedentary Behaviors in Latino Children in the United States: Integrative Review",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="30",
volume="4",
number="1",
pages="e14",
keywords="parenting",
keywords="styles",
keywords="practices",
keywords="physical activity",
keywords="children",
keywords="Hispanic",
keywords="Latino",
abstract="Background: Research indicates that parents influence their children's physical activity (PA) and sedentary behaviors (SB) through their parenting styles and practices. Objective: The objectives of this paper were to evaluate existing research examining the associations between parenting styles, parenting practices, and PA and SB among Latino children aged between 2 and 12 years, highlight limitations of the existing research, and generate suggestions for future research. Methods: The method of this integrative review was informed by methods developed by Whittemore and Knafl, which allow for the inclusion of qualitative, quantitative, and mixed-methods studies. Using the Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines, five electronic academic databases (PubMed, SPORTDiscus, PsycINFO, PsycARTICLES, and CINAHL) were searched for peer-reviewed, full-text papers published in English. Of the 641 unique citations identified, 67 full-text papers were retrieved, and 16 were selected for review. Results: The majority of the 16 reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, and only 1 study examined the association between parenting styles and Latino children's PA and SB. Most (n=15) reviewed studies assessed the influence of parenting practices on children's PA and SB, and they provide good evidence that parenting practices such as offering verbal encouragement, prompting the child to be physically active, providing logistic support, engaging and being involved in PA, monitoring, and offering reinforcement and rewards encourage, facilitate, or increase children's PA. The examined studies also provide evidence that parenting practices, such as setting rules and implementing PA restrictions due to safety concerns, weather, and using psychological control discourage, hinder, or decrease children's PA. Conclusions: Because this review found a very small number of studies examining the relationship between parenting styles and Latino children's PA and SB, additional research is needed. Given that the majority of reviewed studies were conducted with predominantly Mexican American or Mexican immigrant samples, additional research examining parenting styles, parenting practices, and PA and SB among multiethnic Latino groups is needed to design interventions tailored to the needs of this ethnically diverse population group. ",
doi="10.2196/publichealth.8159",
url="http://publichealth.jmir.org/2018/1/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29382629"
}


@Article{info:doi/10.2196/publichealth.7726,
author="Simpson, S. Sean
and Adams, Nikki
and Brugman, M. Claudia
and Conners, J. Thomas",
title="Detecting Novel and Emerging Drug Terms Using Natural Language Processing: A Social Media Corpus Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="08",
volume="4",
number="1",
pages="e2",
keywords="natural language processing",
keywords="street drugs",
keywords="social media",
keywords="vocabulary",
abstract="Background: With the rapid development of new psychoactive substances (NPS) and changes in the use of more traditional drugs, it is increasingly difficult for researchers and public health practitioners to keep up with emerging drugs and drug terms. Substance use surveys and diagnostic tools need to be able to ask about substances using the terms that drug users themselves are likely to be using. Analyses of social media may offer new ways for researchers to uncover and track changes in drug terms in near real time. This study describes the initial results from an innovative collaboration between substance use epidemiologists and linguistic scientists employing techniques from the field of natural language processing to examine drug-related terms in a sample of tweets from the United States. Objective: The objective of this study was to assess the feasibility of using distributed word-vector embeddings trained on social media data to uncover previously unknown (to researchers) drug terms. Methods: In this pilot study, we trained a continuous bag of words (CBOW) model of distributed word-vector embeddings on a Twitter dataset collected during July 2016 (roughly 884.2 million tokens). We queried the trained word embeddings for terms with high cosine similarity (a proxy for semantic relatedness) to well-known slang terms for marijuana to produce a list of candidate terms likely to function as slang terms for this substance. This candidate list was then compared with an expert-generated list of marijuana terms to assess the accuracy and efficacy of using word-vector embeddings to search for novel drug terminology. Results: The method described here produced a list of 200 candidate terms for the target substance (marijuana). Of these 200 candidates, 115 were determined to in fact relate to marijuana (65 terms for the substance itself, 50 terms related to paraphernalia). This included 30 terms which were used to refer to the target substance in the corpus yet did not appear on the expert-generated list and were therefore considered to be successful cases of uncovering novel drug terminology. Several of these novel terms appear to have been introduced as recently as 1 or 2 months before the corpus time slice used to train the word embeddings. Conclusions: Though the precision of the method described here is low enough as to still necessitate human review of any candidate term lists generated in such a manner, the fact that this process was able to detect 30 novel terms for the target substance based only on one month's worth of Twitter data is highly promising. We see this pilot study as an important proof of concept and a first step toward producing a fully automated drug term discovery system capable of tracking emerging NPS terms in real time. ",
doi="10.2196/publichealth.7726",
url="http://publichealth.jmir.org/2018/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29311050"
}


@Article{info:doi/10.2196/publichealth.9282,
author="Hohl, M. Corinne
and Small, S. Serena
and Peddie, David
and Badke, Katherin
and Bailey, Chantelle
and Balka, Ellen",
title="Why Clinicians Don't Report Adverse Drug Events: Qualitative Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="27",
volume="4",
number="1",
pages="e21",
keywords="adverse events",
keywords="pharmacovigilance",
keywords="drug safety",
keywords="adverse drug reaction",
keywords="adverse drug event",
keywords="electronic health records",
keywords="information and technology",
keywords="medication reconciliation",
keywords="qualitative research",
abstract="Background: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. Objective: Our objectives were to identify barriers to adverse drug event documentation and factors contributing to underreporting. Methods: This qualitative study was conducted in 1 ambulatory center, and the emergency departments and inpatient wards of 3 acute care hospitals in British Columbia between March 2014 and December 2016. We completed workplace observations and focus groups with general practitioners, hospitalists, emergency physicians, and hospital and community pharmacists. We analyzed field notes by coding and iteratively analyzing our data to identify emerging concepts, generate thematic and event summaries, and create workflow diagrams. Clinicians validated emerging concepts by applying them to cases from their clinical practice. Results: We completed 238 hours of observations during which clinicians investigated 65 suspect adverse drug events. The observed events were often complex and diagnosed over time, requiring the input of multiple providers. Providers documented adverse drug events in charts to support continuity of care but never reported them to external agencies. Providers faced time constraints, and reporting would have required duplication of documentation. Conclusions: Existing reporting systems are not suited to capture the complex nature of adverse drug events or adapted to workflow and are simply not used by frontline clinicians. Systems that are integrated into electronic medical records, make use of existing data to avoid duplication of documentation, and generate alerts to improve safety may address the shortcomings of existing systems and generate robust adverse drug event data as a by-product of safer care. ",
doi="10.2196/publichealth.9282",
url="http://publichealth.jmir.org/2018/1/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29487041"
}


@Article{info:doi/10.2196/publichealth.9490,
author="Schnelle, Christoph
and Minford, J. Eunice
and McHardy, Vanessa
and Keep, Jane",
title="Comparative Analysis of Women With Notable Subjective Health Indicators Compared With Participants in the Australian Longitudinal Study on Women's Health: Cross-Sectional Survey",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="10",
volume="4",
number="1",
pages="e6",
keywords="women's health",
keywords="health surveys",
keywords="public health",
keywords="Australian Longitudinal Study on Women's Health",
keywords="ALSWH",
keywords="Universal Medicine",
keywords="preventive medicine",
keywords="health care costs",
keywords="complementary therapies",
keywords="cross-sectional studies",
abstract="Background: At least six communities with unusually good health and longevity have been identified, but their lifestyles aren't adopted widely. Informal evidence suggests that women associated with Universal Medicine (UM), a complementary medicine health care organization in Eastern Australia and the United Kingdom with normal lifestyles, also have several unusual health indicators. Objective: Our objective was to determine how UM participants compared with women in the Australian population at large on a variety of health indicators. Methods: In an Internet survey conducted July to September 2015, a total of 449 female UM participants from 15 countries responded to 43 health indicator questions taken from the Australian Longitudinal Study on Women's Health (ALSWH). Results: Survey responses revealed large positive differences in mental and physical health when compared with the ALSWH respondents, except for abnormal Pap test and low iron history. Differences and corresponding effect size estimates (Cohen d; ?0.8 is a high difference, ?0.5 a medium and ?0.2 a small one with P<.001 except where indicated) included body mass index (BMI; 1.11), stress level (0.20, P=.006), depression (0.44), summary physical (0.31) and mental health (0.37), general mental health (0.39), emotional (0.15, P=.009) and social functioning (0.22), vitality (0.58), and general health (0.49), as well as lower incidences of diabetes, hypertension, and thrombosis (P<.001 each). Neither education levels nor country of residence had predictive value. Age did not predict BMI. Conclusions: The women's responses notably claim substantially lower levels of illness and disease than in the general Australian population. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12617000972325; https://www.anzctr. org.au/Trial/Registration/TrialReview.aspx?id=373120\&isReview=true (Archived by WebCite at http://www.webcitation.org/ 6wEDDn45O) International Registered Report Identifier (IRRID): DERR2-10.2196/7993 ",
doi="10.2196/publichealth.9490",
url="http://publichealth.jmir.org/2018/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29321123"
}


@Article{info:doi/10.2196/publichealth.8921,
author="Tustin, Lee Jordan
and Crowcroft, Sarah Natasha
and Gesink, Dionne
and Johnson, Ian
and Keelan, Jennifer",
title="Internet Exposure Associated With Canadian Parents' Perception of Risk on Childhood Immunization: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="19",
volume="4",
number="1",
pages="e7",
keywords="Canadian parents",
keywords="vaccination",
keywords="immunization",
keywords="Internet",
keywords="vaccine safety",
abstract="Background: There is a large presence of provaccination and antivaccination content on the Internet. The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment. No other studies have investigated the association between seeking vaccine information online and Canadian parents' perception of risk on childhood immunization. Objective: We aimed to investigate the potential association between seeking vaccine information on the Internet and Canadian parents' perception of risk on childhood immunization in order to quantify the perceived association and increase our understanding on the impact of the Internet to help guide public health interventions. Methods: We analyzed this association in two population samples: a self-selecting Web-based sample of Canadian parents recruited through Facebook (n=966) and a population-based sample of parents recruited by random digit dialing (RDD; n=951). The outcome was parental perception of vaccine safety on a seven-point ordinal scale from ``not safe'' to ``extremely safe.'' An ordinal regression model was used to investigate if Internet information seeking on childhood vaccination predicted parental perception of vaccine safety. Results: After adjusting for income level, Internet reliability, age of parent, and region, the odds of perceiving vaccines as less safe rather than more safe were 1.6 times higher (95\% CI 1.3-2.1) for parents who used the Internet to search for vaccination information compared to parents who did not search the Internet in the Web-based sample, and 2.0 times higher (95\% CI 1.6-2.5) in the population-based RDD sample. Conclusions: The results suggest the Internet is significantly associated with Canadian parents' negative perception of vaccine risk. Governmental and scientific sectors should consider the development and implementation of Web-based vaccine interventions to promote confidence in immunization. ",
doi="10.2196/publichealth.8921",
url="http://publichealth.jmir.org/2018/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29351896"
}


@Article{info:doi/10.2196/publichealth.9138,
author="Fukuoka, Yoshimi
and Zhou, Mo
and Vittinghoff, Eric
and Haskell, William
and Goldberg, Ken
and Aswani, Anil",
title="Objectively Measured Baseline Physical Activity Patterns in Women in the mPED Trial: Cluster Analysis",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="01",
volume="4",
number="1",
pages="e10",
keywords="accelerometer",
keywords="physical activity",
keywords="cluster analysis",
keywords="women",
keywords="randomized controlled trial",
keywords="machine learning",
keywords="body mass index",
keywords="metabolism",
keywords="primary prevention",
keywords="mHealth",
abstract="Background: Determining patterns of physical activity throughout the day could assist in developing more personalized interventions or physical activity guidelines in general and, in particular, for women who are less likely to be physically active than men. Objective: The aims of this report are to identify clusters of women based on accelerometer-measured baseline raw metabolic equivalent of task (MET) values and a normalized version of the METs ?3 data, and to compare sociodemographic and cardiometabolic risks among these identified clusters. Methods: A total of 215 women who were enrolled in the Mobile Phone Based Physical Activity Education (mPED) trial and wore an accelerometer for at least 8 hours per day for the 7 days prior to the randomization visit were analyzed. The k-means clustering method and the Lloyd algorithm were used on the data. We used the elbow method to choose the number of clusters, looking at the percentage of variance explained as a function of the number of clusters. Results: The results of the k-means cluster analyses of raw METs revealed three different clusters. The unengaged group (n=102) had the highest depressive symptoms score compared with the afternoon engaged (n=65) and morning engaged (n=48) groups (overall P<.001). Based on a normalized version of the METs ?3 data, the moderate-to-vigorous physical activity (MVPA) evening peak group (n=108) had a higher body mass index (P=.03), waist circumference (P=.02), and hip circumference (P=.03) than the MVPA noon peak group (n=61). Conclusions: Categorizing physically inactive individuals into more specific activity patterns could aid in creating timing, frequency, duration, and intensity of physical activity interventions for women. Further research is needed to confirm these cluster groups using a large national dataset. Trial Registration: ClinicalTrials.gov NCT01280812; https://clinicaltrials.gov/ct2/show/NCT01280812 (Archived by WebCite at http://www.webcitation.org/6vVyLzwft) ",
doi="10.2196/publichealth.9138",
url="http://publichealth.jmir.org/2018/1/e10/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29391341"
}


@Article{info:doi/10.2196/publichealth.9221,
author="Castel, D. Amanda
and Terzian, Arpi
and Opoku, Jenevieve
and Happ, Powers Lindsey
and Younes, Naji
and Kharfen, Michael
and Greenberg, Alan
and ",
title="Defining Care Patterns and Outcomes Among Persons Living with HIV in Washington, DC: Linkage of Clinical Cohort and Surveillance Data",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="16",
volume="4",
number="1",
pages="e23",
keywords="HIV/AIDS",
keywords="health information technology",
keywords="surveillance",
keywords="retention",
keywords="viral suppression",
keywords="antiretroviral therapy",
abstract="Background: Triangulation of data from multiple sources such as clinical cohort and surveillance data can help improve our ability to describe care patterns, service utilization, comorbidities, and ultimately measure and monitor clinical outcomes among persons living with HIV infection. Objectives: The objective of this study was to determine whether linkage of clinical cohort data and routinely collected HIV surveillance data would enhance the completeness and accuracy of each database and improve the understanding of care patterns and clinical outcomes. Methods: We linked data from the District of Columbia (DC) Cohort, a large HIV observational clinical cohort, with Washington, DC, Department of Health (DOH) surveillance data between January 2011 and June 2015. We determined percent concordance between select variables in the pre- and postlinked databases using kappa test statistics. We compared retention in care (RIC), viral suppression (VS), sexually transmitted diseases (STDs), and non-HIV comorbid conditions (eg, hypertension) and compared HIV clinic visit patterns determined using the prelinked database (DC Cohort) versus the postlinked database (DC Cohort + DOH) using chi-square testing. Additionally, we compared sociodemographic characteristics, RIC, and VS among participants receiving HIV care at ?3 sites versus <3 sites using chi-square testing. Results: Of the 6054 DC Cohort participants, 5521 (91.19\%) were included in the postlinked database and enrolled at a single DC Cohort site. The majority of the participants was male, black, and had men who have sex with men (MSM) as their HIV risk factor. In the postlinked database, 619 STD diagnoses previously unknown to the DC Cohort were identified. Additionally, the proportion of participants with RIC was higher compared with the prelinked database (59.83\%, 2678/4476 vs 64.95\%, 2907/4476; P<.001) and the proportion with VS was lower (87.85\%, 2277/2592 vs 85.15\%, 2391/2808; P<.001). Almost a quarter of participants (23.06\%, 1279/5521) were identified as receiving HIV care at ?2 sites (postlinked database). The participants using ?3 care sites were more likely to achieve RIC (80.7\%, 234/290 vs 62.61\%, 2197/3509) but less likely to achieve VS (72.3\%, 154/213 vs 89.51\%, 1869/2088). The participants using ?3 care sites were more likely to have unstable housing (15.1\%, 64/424 vs 8.96\%, 380/4242), public insurance (86.1\%, 365/424 vs 57.57\%, 2442/4242), comorbid conditions (eg, hypertension) (37.7\%, 160/424 vs 22.98\%, 975/4242), and have acquired immunodeficiency syndrome (77.8\%, 330/424 vs 61.20\%, 2596/4242) (all P<.001). Conclusions: Linking surveillance and clinical data resulted in the improved completeness of each database and a larger volume of available data to evaluate HIV outcomes, allowing for refinement of HIV care continuum estimates. The postlinked database also highlighted important differences between participants who sought HIV care at multiple clinical sites. Our findings suggest that combined datasets can enhance evaluation of HIV-related outcomes across an entire metropolitan area. Future research will evaluate how to best utilize this information to improve outcomes in addition to monitoring them. ",
doi="10.2196/publichealth.9221",
url="http://publichealth.jmir.org/2018/1/e23/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29549065"
}


@Article{info:doi/10.2196/publichealth.8581,
author="Rudolph, Abby
and Tobin, Karin
and Rudolph, Jonathan
and Latkin, Carl",
title="Web-Based Survey Application to Collect Contextually Relevant Geographic Data With Exposure Times: Application Development and Feasibility Testing",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="19",
volume="4",
number="1",
pages="e12",
keywords="spatial analysis",
keywords="geographic mapping",
keywords="substance-related disorder",
abstract="Background: Although studies that characterize the risk environment by linking contextual factors with individual-level data have advanced infectious disease and substance use research, there are opportunities to refine how we define relevant neighborhood exposures; this can in turn reduce the potential for exposure misclassification. For example, for those who do not inject at home, injection risk behaviors may be more influenced by the environment where they inject than where they live. Similarly, among those who spend more time away from home, a measure that accounts for different neighborhood exposures by weighting each unique location proportional to the percentage of time spent there may be more correlated with health behaviors than one's residential environment. Objective: This study aimed to develop a Web-based application that interacts with Google Maps application program interfaces (APIs) to collect contextually relevant locations and the amount of time spent in each. Our analysis examined the extent of overlap across different location types and compared different approaches for classifying neighborhood exposure. Methods: Between May 2014 and March 2017, 547 participants enrolled in a Baltimore HIV care and prevention study completed an interviewer-administered Web-based survey that collected information about where participants were recruited, worked, lived, socialized, injected drugs, and spent most of their time. For each location, participants gave an address or intersection which they confirmed using Google Map and Street views. Geographic coordinates (and hours spent in each location) were joined to neighborhood indicators by Community Statistical Area (CSA). We computed a weighted exposure based on the proportion of time spent in each unique location. We compared neighborhood exposures based on each of the different location types with one another and the weighted exposure using analysis of variance with Bonferroni corrections to account for multiple comparisons. Results: Participants reported spending the most time at home, followed by the location where they injected drugs. Injection locations overlapped most frequently with locations where people reported socializing and living or sleeping. The least time was spent in the locations where participants reported earning money and being recruited for the study; these locations were also the least likely to overlap with other location types. We observed statistically significant differences in neighborhood exposures according to the approach used. Overall, people reported earning money in higher-income neighborhoods and being recruited for the study and injecting in neighborhoods with more violent crime, abandoned houses, and poverty. Conclusions: This analysis revealed statistically significant differences in neighborhood exposures when defined by different locations or weighted based on exposure time. Future analyses are needed to determine which exposure measures are most strongly associated with health and risk behaviors and to explore whether associations between individual-level behaviors and neighborhood exposures are modified by exposure times. ",
doi="10.2196/publichealth.8581",
url="http://publichealth.jmir.org/2018/1/e12/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29351899"
}


@Article{info:doi/10.2196/publichealth.9321,
author="Baral, Stefan
and Turner, M. Rachael
and Lyons, E. Carrie
and Howell, Sean
and Honermann, Brian
and Garner, Alex
and Hess III, Robert
and Diouf, Daouda
and Ayala, George
and Sullivan, S. Patrick
and Millett, Greg",
title="Population Size Estimation of Gay and Bisexual Men and Other Men Who Have Sex With Men Using Social Media-Based Platforms",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="08",
volume="4",
number="1",
pages="e15",
keywords="AIDS",
keywords="estimates",
keywords="HIV",
keywords="key populations",
keywords="men who have sex with men",
keywords="social media",
abstract="Background: Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. Objective: This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. Methods: Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, C{\^o}te d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. Results: The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. Conclusions: The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates. ",
doi="10.2196/publichealth.9321",
url="http://publichealth.jmir.org/2018/1/e15/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29422452"
}


@Article{info:doi/10.2196/publichealth.9407,
author="Rao, Amrita
and Stahlman, Shauna
and Hargreaves, James
and Weir, Sharon
and Edwards, Jessie
and Rice, Brian
and Kochelani, Duncan
and Mavimbela, Mpumelelo
and Baral, Stefan",
title="Authorship Correction: Sampling Key Populations for HIV Surveillance: Results From Eight Cross-Sectional Studies Using Respondent-Driven Sampling and Venue-Based Snowball Sampling",
journal="JMIR Public Health Surveill",
year="2018",
month="Jan",
day="15",
volume="4",
number="1",
pages="e9",
doi="10.2196/publichealth.9407",
url="http://publichealth.jmir.org/2018/1/e9/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29334478"
}


@Article{info:doi/10.2196/publichealth.9386,
author="Rice, Brian
and Sanchez, Travis
and Baral, Stefan
and Mee, Paul
and Sabin, Keith
and Garcia-Calleja, M. Jesus
and Hargreaves, James",
title="Know Your Epidemic, Strengthen Your Response: Developing a New HIV Surveillance Architecture to Guide HIV Resource Allocation and Target Decisions",
journal="JMIR Public Health Surveill",
year="2018",
month="Feb",
day="14",
volume="4",
number="1",
pages="e18",
keywords="HIV",
keywords="data",
keywords="systems",
keywords="surveillance",
keywords="testing",
keywords="treatment",
keywords="prevention",
keywords="monitoring",
keywords="key populations",
doi="10.2196/publichealth.9386",
url="http://publichealth.jmir.org/2018/1/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29444766"
}


@Article{info:doi/10.2196/publichealth.7375,
author="Yano, Terdsak
and Phornwisetsirikun, Somphorn
and Susumpow, Patipat
and Visrutaratna, Surasing
and Chanachai, Karoon
and Phetra, Polawat
and Chaisowwong, Warangkhana
and Trakarnsirinont, Pairat
and Hemwan, Phonpat
and Kaewpinta, Boontuan
and Singhapreecha, Charuk
and Kreausukon, Khwanchai
and Charoenpanyanet, Arisara?
and Robert, Sripun Chongchit
and Robert, Lamar
and Rodtian, Pranee
and Mahasing, Suteerat
and Laiya, Ekkachai
and Pattamakaew, Sakulrat
and Tankitiyanon, Taweesart
and Sansamur, Chalutwan
and Srikitjakarn, Lertrak",
title="A Participatory System for Preventing Pandemics of Animal Origins: Pilot Study of the Participatory One Health Disease Detection (PODD) System",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="21",
volume="4",
number="1",
pages="e25",
keywords="community-owned disease surveillance system",
keywords="PODD",
keywords="mobile app",
keywords="one health",
keywords="participatory approach",
keywords="backyard chicken",
keywords="pandemic prevention",
abstract="Background: Aiming for early disease detection and prompt outbreak control, digital technology with a participatory One Health approach was used to create a novel disease surveillance system called Participatory One Health Disease Detection (PODD). PODD is a community-owned surveillance system that collects data from volunteer reporters; identifies disease outbreak automatically; and notifies the local governments (LGs), surrounding villages, and relevant authorities. This system provides a direct and immediate benefit to the communities by empowering them to protect themselves. Objective: The objective of this study was to determine the effectiveness of the PODD system for the rapid detection and control of disease outbreaks. Methods: The system was piloted in 74 LGs in Chiang Mai, Thailand, with the participation of 296 volunteer reporters. The volunteers and LGs were key participants in the piloting of the PODD system. Volunteers monitored animal and human diseases, as well as environmental problems, in their communities and reported these events via the PODD mobile phone app. LGs were responsible for outbreak control and provided support to the volunteers. Outcome mapping was used to evaluate the performance of the LGs and volunteers. Results: LGs were categorized into one of the 3 groups based on performance: A (good), B (fair), and C (poor), with the majority (46\%,34/74) categorized into group B. Volunteers were similarly categorized into 4 performance groups (A-D), again with group A showing the best performance, with the majority categorized into groups B and C. After 16 months of implementation, 1029 abnormal events had been reported and confirmed to be true reports. The majority of abnormal reports were sick or dead animals (404/1029, 39.26\%), followed by zoonoses and other human diseases (129/1029, 12.54\%). Many potentially devastating animal disease outbreaks were detected and successfully controlled, including 26 chicken high mortality outbreaks, 4 cattle disease outbreaks, 3 pig disease outbreaks, and 3 fish disease outbreaks. In all cases, the communities and animal authorities cooperated to apply community contingency plans to control these outbreaks, and community volunteers continued to monitor the abnormal events for 3 weeks after each outbreak was controlled. Conclusions: By design, PODD initially targeted only animal diseases that potentially could emerge into human pandemics (eg, avian influenza) and then, in response to community needs, expanded to cover human health and environmental health issues. ",
doi="10.2196/publichealth.7375",
url="http://publichealth.jmir.org/2018/1/e25/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29563079"
}


@Article{info:doi/10.2196/publichealth.8953,
author="Katapally, Reddy Tarun
and Bhawra, Jasmin
and Leatherdale, T. Scott
and Ferguson, Leah
and Longo, Justin
and Rainham, Daniel
and Larouche, Richard
and Osgood, Nathaniel",
title="The SMART Study, a Mobile Health and Citizen Science Methodological Platform for Active Living Surveillance, Integrated Knowledge Translation, and Policy Interventions: Longitudinal Study",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="27",
volume="4",
number="1",
pages="e31",
keywords="exercise",
keywords="sedentary lifestyle",
keywords="smartphone",
keywords="ecological momentary assessments",
keywords="epidemiological monitoring",
keywords="translational medical research",
keywords="health policy",
abstract="Background: Physical inactivity is the fourth leading cause of death worldwide, costing approximately US \$67.5 billion per year to health care systems. To curb the physical inactivity pandemic, it is time to move beyond traditional approaches and engage citizens by repurposing sedentary behavior (SB)--enabling ubiquitous tools (eg, smartphones). Objective: The primary objective of the Saskatchewan, let's move and map our activity (SMART) Study was to develop a mobile and citizen science methodological platform for active living surveillance, knowledge translation, and policy interventions. This methodology paper enumerates the SMART Study platform's conceptualization, design, implementation, data collection procedures, analytical strategies, and potential for informing policy interventions. Methods: This longitudinal investigation was designed to engage participants (ie, citizen scientists) in Regina and Saskatoon, Saskatchewan, Canada, in four different seasons across 3 years. In spring 2017, pilot data collection was conducted, where 317 adult citizen scientists (?18 years) were recruited in person and online. Citizen scientists used a custom-built smartphone app, Ethica (Ethica Data Services Inc), for 8 consecutive days to provide a complex series of objective and subjective data. Citizen scientists answered a succession of validated surveys that were assigned different smartphone triggering mechanisms (eg, user-triggered and schedule-triggered). The validated surveys captured physical activity (PA), SB, motivation, perception of outdoor and indoor environment, and eudaimonic well-being. Ecological momentary assessments were employed on each day to capture not only PA but also physical and social contexts along with barriers and facilitators of PA, as relayed by citizen scientists using geo-coded pictures and audio files. To obtain a comprehensive objective picture of participant location, motion, and compliance, 6 types of sensor-based (eg, global positioning system and accelerometer) data were surveilled for 8 days. Initial descriptive analyses were conducted using geo-coded photographs and audio files. Results: Pictures and audio files (ie, community voices) showed that the barriers and facilitators of active living included intrinsic or extrinsic motivations, social contexts, and outdoor or indoor environment, with pets and favorable urban design featuring as the predominant facilitators, and work-related screen time proving to be the primary barrier. Conclusions: The preliminary pilot results show the flexibility of the SMART Study surveillance platform in identifying and addressing limitations based on empirical evidence. The results also show the successful implementation of a platform that engages participants to catalyze policy interventions. Although SMART Study is currently geared toward surveillance, using the same platform, active living interventions could be remotely implemented. SMART Study is the first mobile, citizen science surveillance platform utilizing a rigorous, longitudinal, and mixed-methods investigation to temporally capture behavioral data for knowledge translation and policy interventions. ",
doi="10.2196/publichealth.8953",
url="http://publichealth.jmir.org/2018/1/e31/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29588267"
}


@Article{info:doi/10.2196/publichealth.7026,
author="Kazi, Momin Abdul
and Ali, Murtaza
and Zubair, Khurram
and Kalimuddin, Hussain
and Kazi, Nafey Abdul
and Iqbal, Perwaiz Saleem
and Collet, Jean-Paul
and Ali, Asad Syed",
title="Effect of Mobile Phone Text Message Reminders on Routine Immunization Uptake in Pakistan: Randomized Controlled Trial",
journal="JMIR Public Health Surveill",
year="2018",
month="Mar",
day="07",
volume="4",
number="1",
pages="e20",
keywords="SMS",
keywords="mobile phone",
keywords="reminders",
keywords="low- and middle-income countries",
keywords="routine immunization",
keywords="children",
abstract="Background: Improved routine immunization (RI) coverage is recommended as the priority public health strategy to decrease vaccine-preventable diseases and eradicate polio in Pakistan and worldwide. Objective: The objective of this study was to ascertain whether customized, automated, one-way text messaging (short message service, SMS) reminders delivered to caregivers via mobile phones when a child is due for an RI visit can improve vaccination uptake and timelines in Pakistan. Methods: This was a randomized controlled trial, conducted in an urban squatter settlement area of Karachi, Pakistan. Infants less than 2 weeks of age with at least one family member who had a valid mobile phone connection and was comfortable receiving and reading SMS text messages were included. Participants were randomized to the intervention (standard care + one-way SMS reminder) or control (standard care) groups. The primary outcome was to compare the proportion of children immunized up to date at 18 weeks of age. Vaccine given at 6, 10, and 14 weeks schedule includes DPT-Hep-B-Hib vaccine (ie, diphtheria, pertussis, and tetanus; hepatitis B; and Haemophilus influenza type b) and oral poliovirus vaccine (OPV). Data were analyzed using chi-square tests of independence and tested for both per protocol (PP) and intention-to-treat (ITT) analyses. Results: Out of those approached, 84.3\% (300/356) of the participants were eligible for enrollment and 94.1\% (318/338) of the participants had a working mobile phone. Only children in the PP analyses, who received an SMS reminder for vaccine uptake at 6 weeks visit, showed a statistically significant difference (96.0\%, 86/90 vs 86.4\%, 102/118; P=.03).The immunization coverage was consistently higher in the intervention group according to ITT analyses at the 6 weeks scheduled visit (76.0\% vs 71.3\%, P=.36). The 10 weeks scheduled visit (58.7\% vs 52.7\%, P=.30) and the 14 weeks scheduled visit (31.3\% vs 26.0\%, P=.31), however, were not statistically significant. Conclusions: Automated simple one-way SMS reminders in local languages might be feasible for improving routine vaccination coverage. Whether one-way SMS reminders alone can have a strong impact on parental attitudes and behavior for improvement of RI coverage and timeliness needs to be further evaluated by better-powered studies and by comparing different types and content of text messages in low-and middle-income countries (LMICs). Trial Registration: ClinicalTrials.gov NCT01859546; https://clinicaltrials.gov/ct2/show/NCT01859546 (Archived by WebCite at http://www.webcitation.org/6xFr57AOc) ",
doi="10.2196/publichealth.7026",
url="http://publichealth.jmir.org/2018/1/e20/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29514773"
}