BackgroundCommunity health workers (CHWs) are an essential and rapidly growing part of the public health workforce. CHW activities are traditionally conducted in person, such as in clinics and at community events; social media could further extend their impact. Many health professionals use social media for disseminating health information, engaging patients, and promoting positive health change, while also navigating risks, such as privacy concerns. Training could be an effective approach to equipping CHWs with skills to maximize social media’s benefits while mitigating risks. Furthermore, artificial intelligence (AI) tools are increasingly popular for creating, refining, or tailoring social media content and could be useful for CHWs who use social media. In this study, we conducted qualitative interviews to explore the potential benefits and drawbacks of using social media as a CHW tool, CHW preferences for social media skills training, and interest in learning how to use AI for social media content creation.MethodsWe recruited CHWs in Louisiana, USA, through targeted e-mails to a CHW professional organization and agencies that employ CHWs. Between October 2024 and February 2025, we conducted 15 interviews. Interviews were audio-recorded and transcribed for analysis. We used deductive and general inductive approaches to analyze transcripts and generate themes. Results were finalized with input from experienced CHWs.ResultsWe identified five themes related to the benefits and drawbacks of social media use: reach and engagement, privacy and confidentiality, health education, organizational policy and expectations, and time and effort. For example, in terms of reach and engagement, CHWs highlighted social media as being particularly effective for reaching specific groups, such as young people, but also recognized that many clients they serve live in rural areas with limited internet access. All participants were supportive of a social media skills training, except for one. Participants commented on the format, teaching approaches, and content they would like to see in a social media skills training program for CHWs, such as incorporating interactive elements and teaching how to develop culturally sensitive content and navigate personal-professional boundaries. Many CHWs expressed hesitancy about training on how to use AI for content creation, noting concerns about authenticity and accuracy.ConclusionsSocial media could be a powerful tool for boosting outreach efforts and expanding access to health information. However, using social media can present challenges in maintaining personal-professional boundaries and the privacy and confidentiality of CHWs and their clients. Results from our study can be used to inform the development and testing of a social media skills training that is responsive to CHW needs.

BackgroundHealth apps designed to monitor, motivate, and educate people towards their health goals are getting more users and features each time. These apps offer valuable support for self-managing health behaviors and achieving long-term objectives. However, there is limited understanding of user preferences regarding essential app features. The aim of the study is to get insights about potential users’ preferences, in order to tailor better apps for lifestyle management.MethodsWe conducted a three-part web survey with 389 respondents from four countries as part of the DigiCare4You European Union (EU) project. In the first part, we collected the socioeconomic characteristics and health status of each respondent. In the following stage, we asked five questions on a Likert scale to ascertain the individual level of usage and general attitude towards technology. Finally, we performed a discrete choice experiment (DCE) using an unlabeled design and estimated the odds ratio for each feature using conditional logit analysis. We also ran alternative estimations stratifying by non-communicable disease (NCD) patients and non-NCD patients, and explored latent profile analysis (LPA) to understand whether the general attitude towards technology impacts the preference pattern between users.ResultsThe DCE revealed that respondents showed a clear preference for monitoring physical health over emotional status. They favored receiving lifestyle achievement notifications weekly rather than daily, and daily rather than more frequently. Similarly, respondents preferred uploading body weight measurements on a weekly or monthly basis rather than daily. Users expressed a preference for collaborating with their doctors to set exercise and diet goals, rather than either deciding independently or delegating entirely to their doctors. End-users also show a pattern of preferring notifications for goals instead of challenging other users. Preferences regarding the subjects of health content between workout routines, food recipes, and new scientific evidence were not significant; also, no statistical significance was found for the decision between follow-up visits with their doctor in person or remotely. LPA returned two groups regarding their general attitude towards technology: a lower, an intermediate, and a higher usage in their private life based on their responses to the questionnaire. Stratified DCEs have shown heterogeneity of users’ preferences according to their specific attitude towards technology.ConclusionsOur study indicates that potential mobile health (mHealth) app users managing chronic conditions prefer platforms that enable shared responsibility with their doctors in defining health goals while having an intermediate level of interaction frequency with the app. These findings are key to tailoring mHealth apps that can optimize motivation triggers, support healthier lifestyles, and empower patients with chronic conditions.

BackgroundEnhanced recovery after surgery (ERAS) significantly improves outcomes for colorectal surgery, but in publicly funded health services with resource constraints, some targets can be difficult to fully implement. eHealth interventions are increasingly used in surgery to improve outcomes. In 2020, we developed eHealth content to optimise prehabilitation, the delivery of an ERAS program, and postoperative care in a tertiary New Zealand hospital. Our objective was to summarise the clinical outcomes of implementing a patient-orientated eHealth intervention for patients undergoing elective colorectal surgery for neoplasia.MethodsWe conducted a retrospective analysis of clinical outcomes with propensity score matching for patients undergoing elective colorectal resection for neoplastic disease between January 2020 and May 2024. Those using eHealth were compared to patients receiving standard care. Demographic and clinical data were extracted from the Otago Clinical Audit (OCA) database and from the eHealth platform. Complications, length of hospital stay (LOS), and readmission were compared using intention-to-treat (ITT) and per-protocol (PP) analyses.ResultsWe identified 333 patients; 102 using eHealth and 231 receiving standard care. For matched ITT analysis, 102 patients from the standard care group were included. The eHealth group had a significantly shorter LOS [median of 5 vs. 6 days; relative risk (RR) =0.79; 95% confidence interval (CI): 0.71, 0.88; P<0.001] and fewer total complications [27 vs. 51; odds ratio (OR) =0.60; 95% CI: 0.30, 1.22; P=0.03]. Readmissions were not significantly different between groups. The eHealth platform was well-liked, with 72% of interactions rated as “very helpful”.ConclusionsPatient support through eHealth, with a focus on prehabilitation as well as postoperative recovery, can be used to effectively supplement ERAS pathways and improve clinical outcomes.

Background: Community health workers (CHWs) are an essential and rapidly growing part of the public health workforce. CHW activities are traditionally conducted in person, such as in clinics and at community events; social media could further extend their impact. Many health professionals use social media for disseminating health information, engaging patients, and promoting positive health change, while also navigating risks, such as privacy concerns. Training could be an effective approach to equipping CHWs with skills to maximize social media’s benefits while mitigating risks. Furthermore, artificial intelligence (AI) tools are increasingly popular for creating, refining, or tailoring social media content and could be useful for CHWs who use social media. In this study, we conducted qualitative interviews to explore the potential benefits and drawbacks of using social media as a CHW tool, CHW preferences for social media skills training, and interest in learning how to use AI for social media content creation. Methods: We recruited CHWs in Louisiana, USA, through targeted e-mails to a CHW professional organization and agencies that employ CHWs. Between October 2024 and February 2025, we conducted 15 interviews. Interviews were audio-recorded and transcribed for analysis. We used deductive and general inductive approaches to analyze transcripts and generate themes. Results were finalized with input from experienced CHWs. Results: We identified five themes related to the benefits and drawbacks of social media use: reach and engagement, privacy and confidentiality, health education, organizational policy and expectations, and time and effort. For example, in terms of reach and engagement, CHWs highlighted social media as being particularly effective for reaching specific groups, such as young people, but also recognized that many clients they serve live in rural areas with limited internet access. All participants were supportive of a social media skills training, except for one. Participants commented on the format, teaching approaches, and content they would like to see in a social media skills training program for CHWs, such as incorporating interactive elements and teaching how to develop culturally sensitive content and navigate personal-professional boundaries. Many CHWs expressed hesitancy about training on how to use AI for content creation, noting concerns about authenticity and accuracy. Conclusions: Social media could be a powerful tool for boosting outreach efforts and expanding access to health information. However, using social media can present challenges in maintaining personal-professional boundaries and the privacy and confidentiality of CHWs and their clients. Results from our study can be used to inform the development and testing of a social media skills training that is responsive to CHW needs.

BackgroundDietary and physical activity behaviors can influence the development of breast cancer. This study aimed to evaluate the effectiveness of a web-app-based intervention in improving diet and physical activity among women aged 25–45 years residing in northern Spain.MethodsA randomized experimental study was conducted with two groups: an intervention group (IG) and a control group (CG). The Motiva.Diaf questionnaire was used to evaluate the impact of a web-app-based intervention on dietary and physical activity behaviors (range: 0= lowest adherence, 12= highest adherence to healthy behaviors). Women in the IG participated in a 12-week intervention based on the Behavior Change Wheel Model. The web-app provided information on both behaviors.ResultsA total of 289 women completed the study (IG =101; CG =188). Considering the combined behaviors for IG (diet and physical activity), between PRE-intervention [8.12; standard deviation (SD) =2.51] and POST-intervention (8.46; SD =2.53), the score was significantly higher in POST [P=0.001; 95% confidence interval (CI): −0.546 to −0.140]. Similarly, significant improvements were observed in specific behavioral recommendations within the IG, with higher scores in dietary behaviors (P<0.001; 95% CI: −0.419 to −0.141), and in physical activity between IG and CG at POST (P=0.04; 95% CI: −0.531 to −0.014). Previous adherence to recommendations was a predictor of POST-intervention adherence to healthy behaviors (Standardized β =0.645; 95% CI: 0.773–0.886; R2 =67%).ConclusionsThe intervention has proven effective in improving adherence to healthy dietary and physical activity behaviors. Policymakers should prioritize the development of these digital interventions as they can play a crucial role in addressing challenges faced by healthcare systems and meeting societal demands. Therefore, healthcare professionals can implement them.Trial RegistrationClinicalTrials.gov NCT05267171.

BackgroundThe digital divide significantly influences healthcare accessibility and outcomes, particularly regarding eHealth technologies. Disparities in eHealth adoption between Europe and Southeast Asia underscore the impact of E-government development on eHealth performance. This study focuses on digital literacy as a mediating factor and religious beliefs as a moderating variable, recognizing that these elements can shape the effectiveness of eHealth initiatives.MethodsA quantitative analysis was conducted using secondary data from 31 geographically diverse countries, representing both developed and emerging economies, spanning the years 2019 to 2022. This period was chosen due to the coronavirus disease 2019 (COVID-19) pandemic, which exacerbated the digital divide in eHealth adoption and accessibility. The analysis examined the relationships between E-government development, digital literacy, religious beliefs, and eHealth performance.ResultsThe findings indicate that E-government development positively influences eHealth performance, with digital literacy playing a significant mediating role in this relationship. Additionally, religious beliefs, particularly Atheism, were found to moderate the relationship between E-government development and eHealth performance. Regions with lower levels of religiosity demonstrated a greater receptiveness to eHealth technologies, suggesting that cultural factors significantly affect technology adoption.ConclusionsThe results underscore the necessity of integrating digital literacy initiatives alongside E-government development to enhance eHealth performance effectively. Policymakers should consider the cultural and religious landscape when designing eHealth strategies to ensure equitable access to healthcare resources. By addressing both technological and cultural barriers, it is possible to improve healthcare accessibility and outcomes for diverse populations, ultimately bridging the digital divide in healthcare.

Telehealth has gained traction since the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) virus [coronavirus disease 2019 (COVID-19)] pandemic. Telehealth is especially useful in plastic surgery, given the visual nature of many plastic surgery problems. However, research on the accessibility of virtual consultations in plastic surgery is limited. The purpose of this study was to evaluate the accessibility of initial virtual consultations in academic and community-based plastic surgery practices through evaluation of online resources and to discuss the implications of these findings as they apply to patient access to care. We evaluated the websites of academic and community-based plastic surgery practices in the USA. All practices were contacted for confirmation of the availability of virtual consultation. Data was collected on practice characteristics, including region, availability of virtual consultations on practice websites, and types of services offered by community-based programs. Standard statistical analysis was performed using chi-square and Fisher's exact tests. A total of 88 academic and 500 community-based plastic surgery practice websites were evaluated. Community-based practices offered more virtual consultations than academic practices (64.5% vs. 25.0%, P<0.001). As it pertains to telehealth marketing, overall availability of virtual consultations on the websites of academic and community-based practices was lacking and there was no difference between the two groups (21.6% vs. 13.8%, respectively, P=0.06). Community-based practices that offered only cosmetic surgery offered more virtual consultations than those that offered both cosmetic and reconstructive surgery (75.0% vs. 54.0%, P<0.001). Our findings suggest that community-based and academic plastic surgery practices are under-utilizing telehealth and telehealth marketing as it applies to virtual consultations. Despite the widespread adoption of telehealth since the COVID-19 pandemic, there is high variability in the accessibility of virtual consultations in plastic surgery across academic and community-based practices and broader implementation should be considered to increase transparency of services and accessibility to care.

For telemedicine to be implemented and sustained in low- and middle-income countries (LMIC), it must be accessible, equitable, affordable, and compatible with current infrastructures. This study is to evaluate the views of pediatric healthcare practitioners in Ethiopia toward using an instant messaging app (Telegram) to conduct tele-consultations and asynchronous medical education. The study adopted a qualitative method via in-person interviews or message exchange to get greater insights and deeper meanings of pediatric doctors in Ethiopia about the use of Telegram chat groups for teleconsultations and medical education. Coding and Thematic analysis were applied to identify common themes and data analysis. The study attracted ten pediatric doctors for in-depth interviews and four text exchanges. All participants expressed positive attitudes toward telemedicine through simpler phone-based platforms. Telegram was the preferred application over WhatsApp and Zoom due to its compatibility with limited internet connections, multidimensional views of data, and an unlimited number of participants. Having a Telegram chat made it easy to get teleconsultation and improve pediatric knowledge. Pediatricians from non-academic institutions and rural areas viewed the chat group as a source of continuous medical education. A rural pediatrician stated, "In our hospital, we don't have morning sessions or case presentations, so it (the group) gives us a platform to read further, to learn further." Residents found Telegram as a vital tool for their learning, with one resident stating, "I think Telegram is part of our residency." Lack of consultation culture, fear of being judged, and hierarchy limited the number of teleconsultations and participation in educational discussions. Internet availability, digital divide, lack of physical exam, and privacy concerns were the main barriers to using Telegram for teleconsultations. Having international experts to answer consultations was viewed as a challenge and an advantage at the same time. It is a challenge when the international expert does not understand the culture or local resources. It is an advantage as the expert can introduce new updates and innovative interventions. A pediatrician said, "There are different groups of experts from here and from abroad as well…Yeah, that makes it an ideal thing.". Telegram is already used by pediatric providers in Ethiopia for telemedicine and medical education. This affordable intervention can improve access and ease the burden of consultations for all providers while meeting current infrastructure. It has potential to be scaled up and regulated to improve pediatric telemedicine in Ethiopia and many LMIC.

Wireless communication devices and networks are currently prevalent in human environment. Some persons claim to be sensitive to emitted by them microwave radiation. Commonly, this sensitivity is called electromagnetic hypersensitivity (EHS) or microwave disease. However, because of the yet scientifically unproven link between radiation exposures and EHS symptoms, this sensitivity is also called idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF). The sensitivity is not recognized by the World Health Organization as a disease or as being caused by exposures to wireless radiation. There are no medical tests for detecting sensitivity to wireless radiation. Physicians are not being educated to deal with persons who claim to be sensitive to wireless radiation. However, some persons who consider themselves to be sensitive to wireless radiation exposures claim to have medical diagnoses made by physicians or other health professionals. This project looked at the contradiction of the lack of diagnostic criteria for sensitivity to wireless radiation with the medical diagnoses claimed by some of the self-declared sensitive persons. Analysis of questionnaire responses of 142 self-declared sensitive persons suggests that, currently, it is not possible to diagnose sensitivity to wireless radiation exposures. The claimed medical diagnoses appear to be based on the anecdotal evidence presented by the self-declared sensitive persons. In some cases, medical tests were used but these tests lacked scientific proof of their ability to detect the sensitivity of a person to wireless radiation exposure. The proof of the existence of sensitivity to wireless radiation remains inadequate. However, logically and by analogy to other environmental stressors, it is likely that individual sensitivity to wireless radiation exists. Because provocation studies in wireless radiation-exposed volunteers alone seem unable to provide definite answers, further research using both, provocation and biochemical methods with controlled wireless radiation exposures in volunteers is necessary to discover diagnostic biomarkers of EHS.