Effect of Posting on Social Media on Systolic Blood Pressure and Management of Hypertension: A Randomized Controlled Trial

Background Online platforms are used to manage aspects of our lives including health outside clinical settings. Little is known about the effectiveness of using online platforms to manage hypertension. We assessed effects of tweeting/retweeting cardiovascular health content by individuals with poorly controlled hypertension on systolic blood pressure (SBP) and patient activation. Methods and Results We conducted this 2‐arm randomized controlled trial. Eligibility included diagnosis of hypertension; SBP >140 mm Hg; and an existing Twitter account or willingness to create one to follow study Twitter account. Intervention arm was asked to tweet/retweet health content 2×/week using a specific hashtag for study duration (6 months). The main measures include primary outcome change in SBP; secondary outcome point change in Patient Activation Measure (PAM). We remotely recruited and enrolled 611 participants, mean age 52 (SD, 11.7). Mean baseline SBP for the intervention group was 155.8 and for control was 155.6. At 6 months, mean SBP for intervention group was 137.6 and for control was 135.7. Mean change in SBP from baseline to 6 months for the intervention group was −18.5 and for control was −19.8 (P =0.48). Mean PAM at baseline for the intervention group was 70.3 for control was 72.7. At 6 months, mean PAM scores were 71.1 (intervention) and 75.6 (control). Mean change in PAM score for the intervention group was 0.0 and for control was 3.3 ( P =0.12). Conclusions Recruiting and engaging patients and collecting outcome measures remotely are feasible using Twitter. Encouraging patients with poorly controlled hypertension to tweet or retweet health content on Twitter did not improve SBP or PAM score at 6 months. Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02622256.

Sexual Health Teaching in the Family Medicine Clerkship: Results of a CERA Survey

Introduction: With growing efforts to provide comprehensive and inclusive sexual health care, family medicine clerkships are well positioned to educate learners about a spectrum of related topics. This study investigated the current state of sexual health instruction in family medicine clerkships, including specific factors impacting its delivery. Methods: Questions about sexual health curricula were created and included as part of the 2020 Council of Academic Family Medicine’s Educational Research Alliance survey of family medicine clerkship directors. The survey was distributed via email to 163 recipients between June 1, 2020 and June 25, 2020. Results: One hundred five (64.42%) of 163 clerkship directors responded to the survey. Our results revealed that during family medicine clerkships, family planning, contraception, and pregnancy options counseling are covered significantly more often than topics related to sexual dysfunction and satisfaction and LGBTQ+ health. Most clerkship directors (91.5%) reported less than 5 hours of sexual health training in their curriculum. Those with more dedicated sexual health curricular hours were more likely to include simulation. Lack of time (41.7%) was the most frequently reported barrier to incorporating sexual health content into the clerkship. Conclusions: Coverage of sexual health topics during the family medicine clerkship is limited in scope and delivery. To support curricular development and integration, future studies should more thoroughly examine the factors influencing the inclusion of sexual health content in family medicine clerkships as well as the development of assessment methods to determine competency.

Creating conversation: how Bell Let's Talk produces engaging mental health content on Twitter

This pilot study explores how Bell Let’s Talk, a mental health initiative to foster positive conversation about mental health in Canada, uses Twitter to disseminate mental health messages with the intention of increasing awareness and reducing stigma. A content analysis was conducted of 89 tweets posted by the official Bell Let’s Talk Twitter account, @Bell_LetsTalk between December 1, 2016 and January 31, 2017 to establish the overall engagement of content, examine which content receives the highest engagement and establish which message function creates most conversation. The results suggest Bell Let’s Talk produces medium engagement content. The majority of tweets feature a non-celebrity influencer (n=37) or non-influencer (n=37). However, celebrity content had the highest level of engagement (mdn=1102). Of the communication features used, links were the most frequently utilized (n=52). Public-centric topics (n=45) were the most common type of tweet, yet organizational-centric action tweets received the highest level of engagement (mdn=1382). The results of this pilot study suggest Bell Let’s Talk produces content of medium. They also indicate there is potential for further research to build upon and improve health professionals’ knowledge regarding successful content about mental health on Twitter.

Creating conversation: how Bell Let's Talk produces engaging mental health content on Twitter

This pilot study explores how Bell Let’s Talk, a mental health initiative to foster positive conversation about mental health in Canada, uses Twitter to disseminate mental health messages with the intention of increasing awareness and reducing stigma. A content analysis was conducted of 89 tweets posted by the official Bell Let’s Talk Twitter account, @Bell_LetsTalk between December 1, 2016 and January 31, 2017 to establish the overall engagement of content, examine which content receives the highest engagement and establish which message function creates most conversation. The results suggest Bell Let’s Talk produces medium engagement content. The majority of tweets feature a non-celebrity influencer (n=37) or non-influencer (n=37). However, celebrity content had the highest level of engagement (mdn=1102). Of the communication features used, links were the most frequently utilized (n=52). Public-centric topics (n=45) were the most common type of tweet, yet organizational-centric action tweets received the highest level of engagement (mdn=1382). The results of this pilot study suggest Bell Let’s Talk produces content of medium. They also indicate there is potential for further research to build upon and improve health professionals’ knowledge regarding successful content about mental health on Twitter.

Integration of mental health comorbidity in medical specialty programs in 20 countries

Methods A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented. Results Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content. Discussion The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.

The Health Crisis on Instagram: How the Media Are Building Their Agenda on the Visual Social Network During the COVID-19 Pandemic

Over the last decade social networks have become important channels for the media to publish information and communicate with their younger audi­ences, with Instagram recently becom­ing the most popular platform for this purpose. This article is an investigation into news production on this social net­work in the context of the international crisis generated by the COVID-19 pan­demic, by means of a content analysis of 552 posts published by the two most widely read Spanish newspapers. The results suggest that despite there being a large quantity of soft content and hu­man-interest stories, as found in previ­ous research, Instagram is also used as a platform to distribute information of public interest about the management of the crisis (such as political decisions and health content). Keywords: social networks, Instagram, journalism, COVID-19, agenda.

Professional competencies and public health content in the human nutrition and dietetics degree program: A qualitative study based on experts' consensus

Objective To gather consensus on professional competencies and basic public health content for the degree program in Human Nutrition and Dietetics (HND). Design In 2018, the Fifth Meeting of University Public Health Professors took place in Zaragoza (Spain). Fourteen lecturers in the HND degree program participated from 11 Spanish universities. They identified competencies and basic content for training for the HND degree using group dynamics and consensus strategies. Results The professors identified 51 basic competencies, distributed in the areas of “evaluation of population health needs” (n = 20), “development of health policies” (n = 23), and “guaranteeing provision of health care services” (n = 8). In order to reach these competencies, 35 topics were proposed organized into six thematic blocks: foundations of public health, nutritional epidemiology, health problems and diet and nutrition strategies, food security, health in all policies and health promotion and education. Conclusion The consensus reached serves as a reference to orient and update public health education as a part of the HND degree.