OBJECTIVE: As part of a larger study about pregnancy options counseling with adolescents, we interviewed women in the U.S. who chose abortion during adolescence about preferences and experiences regarding communication from healthcare professionals during abortion care.
METHODS: We conducted individual semi-structured interviews with women ages 18-35 years old who were pregnant before age 20 years old and chose abortion. We recruited participants through social media, a research registry, and flyers in healthcare facilities. We recorded and transcribed interviews. Two investigators coded interview transcripts using thematic analysis.
RESULTS: We conducted interviews with 17 U.S. women (median age 32 years old, range 20-35 years old) from 11/2020-4/2021. The median age at time of abortion was 18 years old (range 14-19 years). The sample was 58% (n=10) Caucasian and 65% (n=11) heterosexual. Themes included: 1) Participants perceived options counseling before abortion as important and necessary, but did not always feel they personally needed it. 2) Participants reported that clinicians including nurses, physicians, and other staff sometimes had poor bedside manner, which was not aligned with their perceived need for gentleness due to their adolescence. 3) Participants valued non-judgmental communication including normalization of abortion care. 4) Participants desired privacy and confidentiality throughout their clinic appointment, but clinic logistics led to concerns about limited privacy. 5) Participants appreciated medically accurate information about abortion in plain language balancing safety and risk information for reducing fear before the procedure.
CONCLUSIONS: Responses suggested specific best practices that healthcare providers can adopt to improve care for youth considering abortion.

OBJECTIVE: We conducted a systematic review of the literature on online health memes to (a) detect and describe the available research, (b) identify key findings, and (c) delineate future research needs/opportunities.
METHODS: Databases, communication and public health journals, and ancestry search.
METHODS: Empirical studies, in English, published in peer-reviewed academic journals, and focused on memes to discuss health-related topics.
METHODS: We scrutinized 357 empirical articles and included 35.
RESULTS: Descriptive summary of the locations where studies were conducted, the health topics addressed, theories and methods used, features of memes analyzed, study outcomes, and researchers\' challenges.
RESULTS: Most studies were conducted in the USA (n = 14); focused on COVID-19 (n = 15); were a-theoretical (n = 19); and quantitative (n = 19). Most explored the themes and use of the memes available online (n = 19); compared meme variations (n = 12) by health issue, content, or participants\' group; examined meme\' effects on health outcomes (n = 1); or evaluated memes as part of a health campaign (n = 3). We summarized the studies\' limitations and key findings.
CONCLUSIONS: Memes are a promising message strategy for health promotion and education, but more research is necessary. Considering the information retrieved, we provide five specific recommendations for future research directions when studying health memes, including suggestions on the multiple health issues to address and promising theories to adopt and expand.

OBJECTIVE: ChatGPT has the potential to offer patient-friendly support. Thyroid carcinoma has become increasingly prevalent in recent years. This study aimed to assess ChatGPT\'s accuracy and adequacy in answering questions about information, management, and emotional support related to thyroid cancer.
METHODS: We conducted a three-step study. In the first step, ChatGPT responded to 30 questions about thyroid cancer. In the second step, we presented three different cases of thyroid cancer patients and asked ChatGPT about their diagnosis, treatment management, and follow-up. In the third step, we inquired about emotional support for patients and their families. Three expert endocrinologists graded these responses according to ATA guidelines.
RESULTS: We showed that ChatGPT regurgitated extensive knowledge of thyroid cancer (76.66% correct), but only small proportions (6.66%) were labeled as mixed with correct and incorrect/outdated data. However, it was inadequate in the evaluation of clinical cases of thyroid cancer. It mentioned treatment and follow-up recommendations in a general framework, not patient-specific. Also, it provided practical and multifaceted emotional support advice to patients and caregivers regarding the next steps and adjusting to a new diagnosis.
CONCLUSIONS: Our study is the first to evaluate the competence and reliability of ChatGPT in thyroid cancer. Although ChatGPT is moderately competent in obtaining information about thyroid cancer, it has not yet been determined to be sufficiently competent and reliable in case management. It has been found effective in guiding patients and their relatives regarding emotional support.

OBJECTIVE: To explore reactions to and preferences for words/phrases used in communications about diabetes among adults with diabetes and parents of children with diabetes.
METHODS: Eligible adults (aged 18+ years) living with diabetes, or parenting a child with diabetes, were recruited via social media to complete an online cross-sectional, mixed-methods survey. Study-specific items were used to examine 22 commonly used diabetes words/phrases in terms of participants\' cognitive perceptions (\'helpful\', \'respectful\', \'accurate\', \'harmful\', \'judgmental\' and \'inaccurate\') and emotional reactions (\'optimistic\', \'motivated\', \'supported\', \'understood\', \'offended\', \'blamed\', \'distressed\' and \'angry\'). Open-ended questions invited further feedback on (non-)preferred language and its impact(s). Data were analysed using descriptive statistics and inductive thematic analysis.
RESULTS: Participants (N = 865) included adults with diabetes (type 1: n = 519; type 2: n = 180, other types: n = 48) and parents of children with diabetes (n = 118). Words/phrases most commonly associated with negative perceptions/emotional responses were \'non-compliant\' (60% judgmental; 47% felt blamed) and \'…good/bad\' (54% judgmental; 43% blamed). Positive perceptions were reported for \'managing diabetes\' (73% helpful, 47% felt understood), \'person with diabetes\' (72% respectful; 49% understood), \'…within/outside target range\' (60% helpful, 44% understood), and \'condition\' (58% respectful; 43% understood). Participants\' qualitative responses illuminated perceptions, experiences and impacts across five themes: (1) accuracy and simplicity; (2) identity; (3) blame, judgement and stigma; (4) respect and trust and; (5) support, hope and feeling understood. Themes were consistent across diabetes types.
CONCLUSIONS: These findings provide novel evidence into (non-)preferred, and potential (negative and positive) impacts of, commonly used diabetes words/phrases, supporting the international #LanguageMatters movement.

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OBJECTIVE: Alcohol use disorder (AUD) is characterized by low levels of engagement with effective treatments. Enhancing awareness of AUD treatments and how to navigate the treatment system is crucial. Many individuals use online sources (e.g. search engines) for answers to health-related questions; web-based results include a mix of high- and low-quality information. Artificial intelligence may improve access to quality health information by providing concise, high-quality responses to complex health-related questions. This study evaluated the quality of ChatGPT-4 responses to AUD-related queries.
METHODS: A comprehensive list of 64 AUD-related questions was developed through a combination of Google Trends analysis and expert consultation. ChatGPT-4 was prompted with each question, followed by a request to provide 3-5 peer-reviewed scientific citations supporting each response. Responses were evaluated for whether they were evidence-based, provided a referral and provided supporting documentation.
RESULTS: ChatGPT-4 responded to all AUD-related queries, with 92.2% (59/64) of responses being fully evidence-based. Although only 12.5% (8/64) of responses included referrals to external resources, all responses (100%; 5/5) to location-specific (\'near me\') queries directed individuals to appropriate resources like the NIAAA Treatment Navigator. Most (85.9%; 55/64) responses to the follow-up question provided supporting documentation.
CONCLUSIONS: ChatGPT-4 responds to alcohol use disorder-related questions with evidence-based information and supporting documentation. ChatGPT-4 could be promoted as a reasonable resource for those looking online for alcohol use disorder-related information.

UNASSIGNED: The accuracy and reliability of health information disseminated through news is crucial, as it directly impacts both individual and societal health outcomes. This study aims to analyze the publication process of health content in Türkiye and its implications for public health. By examining the perspectives of various health communication stakeholders, the study seeks to identify existing issues and propose potential solutions.
UNASSIGNED: The research uses a mixed-methods approach, including baseline content analysis of 846 news by 133 criteria, quantitative research with 78 participants encompassing bureaucrats, academics, journalists, and health association members, and 15 in-depth interviews for comprehensive insights.
UNASSIGNED: The content analysis indicated that 23.2% of the analyzed news articles lacked credible sources, while 63% did not mention the author\'s name. A striking 96.2% of respondents stated that inaccurate health news poses a risk to public health, emphasizing the urgent need for standardized reporting practices. The majority (90.9%) pinpointed the media as the primary catalysts for infodemic spread, with 93.5% citing gatekeepers as barriers to accurate information. Eroding trust in media, fueled by unethical practices, harms both media credibility and effective public health interventions.
UNASSIGNED: The study underscores the necessity for a collaborative approach among public institutions, academia, and media, focusing on responsibility, regulation, and sanctions against the infodemic. The research advocates for a balanced approach that prioritizes health rights and press freedom within a stakeholder-driven framework, highlighting that legislation alone cannot fully enhance the digital information ecosystem.

BACKGROUND: Managing diagnostic uncertainty is a major challenge in primary care due to factors such as the absence of definitive tests, variable symptom presentations and disease evolution. Maintaining patient trust during a period of investigative uncertainty, whilst minimising scope for diagnostic error is a challenge. Mismanagement can lead to diagnostic errors, treatment delays, and suboptimal patient outcomes.
OBJECTIVE: Our aim was to explore how UK primary care physicians (GPs) address and communicate diagnostic uncertainty in practice.
METHODS: This qualitative study used video and audio-recordings. Verbatim transcripts were coded with a modified, validated tool to capture GPs\' actions and communication in primary care consultations that included diagnostic uncertainty. The tool includes items relating to advice regarding new symptoms or symptom deterioration (sometimes called \'safety netting\'). Video data was analysed to identify GP and patient body postures during and after the delivery of the management plan.
METHODS: All patient participants had a consultation with a GP, were over the age of 50 and had (1) at least one new presenting problem or (2) one persistent problem that was undiagnosed.
METHODS: Data collection occurred in GP-patient consultations during 2017-2018 across 7 practices in UK during 2017-2018.
RESULTS: GPs used various management strategies to address diagnostic uncertainty, including (1) symptom monitoring without treatment, (2) prescribed treatment with symptom monitoring, and (3) addressing risks that could arise from administrative tasks. GPs did not make management plans for potential treatment side effects. Specificity of uncertainty management plans varied among GPs, with only some offering detailed actions and timescales. The transfer of responsibility for the management plan to patients was usually delivered rather than negotiated, with most patients confirming acceptance before concluding the discussion.
CONCLUSIONS: We offer guidance to healthcare professionals, improving awareness of using and communicating management plans for diagnostic uncertainty.

BACKGROUND: Previous studies have shown that substantial percentages of emergency department (ED) patients in the USA recommended for HIV or hepatitis C (HCV) decline testing. Evidence-based and cost-effective interventions to improve HIV/HCV testing uptake are needed, particularly for people who inject drugs (PWIDs) (currently or formerly), who comprise a group at higher risk for these infections. We developed a brief persuasive health communication intervention (PHCI) designed to convince ED patients who had declined HIV/HCV testing to agree to be tested. In this investigation, we will determine if the PHCI is more efficacious in convincing ED patients to be tested for HIV/HCV when delivered by a video or in person, and whether efficacy is similar among individuals who currently, previously or never injected drugs.
METHODS: We will conduct a multisite, randomised controlled trial comparing PHCIs delivered by video versus in person by a health educator to determine which delivery method convinces more ED patients who had declined HIV/HCV testing instead to be tested. We will stratify randomisation by PWID status (current, former or never/non-PWID) to permit analyses comparing the PHCI delivery method by injection-drug use history. We will also perform a cost-effectiveness analysis of the interventions compared with current practice, examining the incremental cost-effectiveness ratio between the two interventions for the ED population overall and within individual strata of PWID. As an exploratory analysis, we will assess if a PHCI video with captions confers increased or decreased acceptance of HIV/HCV testing, as compared with a PHCI video without captions.
BACKGROUND: The study protocol has been approved by the institutional review board of the Icahn School of Medicine. The results will be disseminated at international conferences and in peer-reviewed publications.
BACKGROUND: NCT05968573.

BACKGROUND: Direct access of patients to their web-based patient portal, including laboratory test results, has become increasingly common. Numeric laboratory results can be challenging to interpret for patients, which may lead to anxiety, confusion, and unnecessary doctor consultations. Laboratory results can be presented in different formats, but there is limited evidence regarding how these presentation formats impact patients\' processing of the information.
OBJECTIVE: This study aims to synthesize the evidence on effective formats for presenting numeric laboratory test results with a focus on outcomes related to patients\' information processing, including affective perception, perceived magnitude, cognitive perception, perception of communication, decision, action, and memory.
METHODS: The search was conducted in 3 databases (PubMed, Web of Science, and Embase) from inception until May 31, 2023. We included quantitative, qualitative, and mixed methods articles describing or comparing formats for presenting diagnostic laboratory test results to patients. Two reviewers independently extracted and synthesized the characteristics of the articles and presentation formats used. The quality of the included articles was assessed by 2 independent reviewers using the Mixed Methods Appraisal Tool.
RESULTS: A total of 18 studies were included, which were heterogeneous in terms of study design and primary outcomes used. The quality of the articles ranged from poor to excellent. Most studies (n=16, 89%) used mock test results. The most frequently used presentation formats were numerical values with reference ranges (n=12), horizontal line bars with colored blocks (n=12), or a combination of horizontal line bars with numerical values (n=8). All studies examined perception as an outcome, while action and memory were studied in 1 and 3 articles, respectively. In general, participants\' satisfaction and usability were the highest when test results were presented using horizontal line bars with colored blocks. Adding reference ranges or personalized information (eg, goal ranges) further increased participants\' perception. Additionally, horizontal line bars significantly decreased participants\' tendency to search for information or to contact their physician, compared with numerical values with reference ranges.
CONCLUSIONS: In this review, we synthesized available evidence on effective presentation formats for laboratory test results. The use of horizontal line bars with reference ranges or personalized goal ranges increased participants\' cognitive perception and perception of communication while decreasing participants\' tendency to contact their physicians. Action and memory were less frequently studied, so no conclusion could be drawn about a single preferred format regarding these outcomes. Therefore, the use of horizontal line bars with reference ranges or personalized goal ranges is recommended to enhance patients\' information processing of laboratory test results. Further research should focus on real-life settings and diverse presentation formats in combination with outcomes related to patients\' information processing.