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The nutrition and dietetics profession is neither diverse nor inclusive of Black, Indigenous, and People of Color (BIPOC), yet to achieve racial/ethnic diversity, equity, and inclusion (R-DEI), nutrition professionals (educators, preceptors, and professionals) need to understand and care about related issues. However, both a space and curriculum to educate professionals about R-DEI are lacking. Our aim was to understand how knowledge, actions, identity, and experiences are related to beliefs about R-DEI among nutrition professionals. We developed a 20-week curriculum about R-DEI topics using the Transtheoretical Model (Stages of Change) and Critical Race Theory. It was delivered in #InclusiveDietetics, a Facebook group, between January and August 2020. Pre- and post-intervention surveys were used to understand participants’ identities, experiences, knowledge, beliefs, actions, and opinions and analyzed using logistical regression, t-tests, and descriptive statistics. Knowledge (p

Background: For individuals suffering from chronic disease, more than being an information source for health information, social media serves as a dynamic forum for shared goals, emotional and practical support through the sharing of lived experiences. Aim: This study envisaged a content analysis of the 100 most widely-viewed English language videos related to celiac disease posted on TikTok. Methods: TikTok was searched using the hashtag #celiacdisease. This search term was chosen as it represented the broadest summation of the desired topic with the most views (80 million) of any related hashtag. The first 100 English language videos were selected. The video content was analyzed against predetermined descriptive categories, deductively derived content related to facts about celiac disease from a reliable source, and inductive content categories derived during the coding process. Results: The 100 videos included in this study received a total of 44,056,600 likes. The average number of likes across all videos was 440,566 with a standard deviation of 656,642.06. Two of the three categories were present in a majority (>50) of the videos. They were practical information on diet therapy management (n = 63) and challenges in managing celiac disease (n = 73). In both instances, videos featuring this content also garnered a majority of the likes, 74.18% and 82.9% respectively. Independent one-tailed t-tests (α = .05) returned significant results for the diagnosis-related information (p = .0390) and practical information in diet therapy management (p = .0358) categories. On average, videos that included diagnosis-related information received more likes than those that did not: 672,983.33 vs. 340,958.57. Similarly, the average number of likes was significantly higher for videos that included practical information on diet therapy management (518,715.87) vs. those that did not (307,500). Conclusions: This study further confirms the growing trend of people using social media to discuss health issues in a way that is free and easily accessible among communities with shared experiences. The long-term effects of using personal narratives as credible sources of behavioral change for health, medical, or professional resources can be further investigated.

Background Handwashing has long been promoted to maintain health and in preventing disease transmission. One of the most valuable ways to convey messages related to handwashing is through visual display, such as video for educational purposes and to enhance learning. Social media is an important and popular way to disseminate messages to a wide audience. Methods In this cross-sectional, descriptive study, two hashtags, #WashYourHands and #SafeguardSplash were used to select the sample of 100 from available TikTok videos. In order to code each video, the same coding categories were used for both hashtags, including (1) wetting and rinsing hands (2) lathering soap (3) time used for scrubbing (4) drying hands (5) mentions COVID-19 (6) mentions using hand sanitizer instead of soap (7) mentions how germs spread (8) mentions key times to wash hands (9) and actual depiction of washing hands. Additional descriptive categories were coded as well. The observations recorded were tabulated and descriptive statistics were performed. Independent one-tailed t-tests (α = .05) were calculated to determine if a video's hashtag had a significant association with its garnered views, likes, and/or comments. Results In total, the 100-video sample received 1,990,834,567 views, 40,355,468 likes, and 173,422 comments. Despite the fact that each hashtag made up an equal proportion (50%) of the total sample, videos with #WashYourHands accounted for 93.3% of the total views. Coverage of the important steps involved in handwashing, such as drying hands, was minimal as was relevant background information. Conclusion The results indicate that while this opportunity is being realized to some degree, the majority of videos did not cover topics related important concepts of hand hygiene. Given the high engagement of younger audiences with TikTok, this could be a powerful mechanism for demonstrating and encouraging proper handwashing, especially in a population with low rates of handwashing.

The purpose of this study was to determine the readability level of information on 100 unique websites with information on preeclampsia. Five different readability measures were used to measure each website's readability via an online readability calculator. All five readability measures determined that a vast majority of the sites sampled were written at unacceptable levels (89%+). Independent one-tailed t-tests (α = 0.05) determined that there was no statistical difference in the readability scores of.com vs the other websites on any of the 5 readability assessments. We recommend that efforts be made to simplify language in accordance with plain language recommendations for health information in the United States.

OBJECTIVES: Instagram is a popular social media site used by high numbers of young people. This study was designed to investigate COVID-19 content on Instagram during the month following official pandemic status from the World Health Organization (WHO). METHODS: A total of 200 posts were collected and analyzed over a four-week period between mid-February and mid-March 2020. RESULTS: The vast majority of posts did not address recommended prevention measures. Further, only approximately one-third of the posts referenced a reputable source. Finally, the nature of posts changed over time was impacted by type of poster and reflected a tone of anxiety. CONCLUSIONS: The findings underscore the urgent need for public health officials to be aware of and address social media content on novel health threats. Furthermore, it is imperative that communicating risk on social media, such as Instagram be geared to young people. Failure to do so may hinder prevention, mitigation, and suppression strategies.

While genetic and hormonal factors likely play a role in the development of obesity, lifestyle issues such as diet and physical activity are main contributors. Lifestyle issues are largely influenced by environmental factors, which pertain not only to access and availability, but exposure to opportunities for unplanned food and beverage purchases. The purpose of this study was to describe the extent to which candy, snack foods, and sugary beverages are available in checkout lines in a convenience sample retail chain stores in NYC that sell products for children. Non-probability, convenience sampling was used to select a total of 22 stores to visit in person. All stores were visited and the checkout lines were observed, capturing both the checkout style (single lane versus multiple lane; corralled or non-corralled), and the products (if any) being sold. Of the 22 stores surveyed, 17 (77.27%) sold at least one convenience food (candy and snacks), and/or sugary beverages. Among the stores that sell convenience food, nearly all (82.35%) sell candy, 100% of those with no corral-style line and 76.92% of those using a corral-style line. The findings from this study concur with prior research indicating that non-nutritious food items and sugary beverages have a presence at checkout areas of retail stores, thus driving the possibility for impulse buys. Exposure to messaging and ques are potentially influential on public health, and should be a point of reflection in terms of the kinds of policies that can support or hinder public health.

The COVID-19 pandemic first became evident at the end of 2019, and because of the many unknown aspects of this emerging infectious disease, the internet quickly became a source of information for consumers. It is important for any vital information to be written unambiguously, and at a level that can be understood by all people regardless of education levels. The purpose of this study was to assess the readability of 50 sources of COVID19 testing information online. Only 6 websites out of 50 received an appropriate readability score on more than one assessment. One-sample, one-tailed t-tests (α = 0.05, df = 49) were used to see if the websites with information on COVID-19 testing are being written at appropriate reading levels. The resulting p-values indicate that each p-value recorded is substantially below 0.05, it is very unlikely that websites on this topic are being written at the recommended levels. Even the optimal messages on COVID-19 reflect a confusing and rapidly changing public health crisis, however if messages are kept simple and clear, individuals will have the best possible chance of optimizing behavioral mitigation strategies. These are compelling reasons for informational hosts to take necessary steps to ensure that messages are written in as simple terms as possible. To this end, it is suggested that internet sites dispersing COVID-19 testing information build in text analysis methods for all published messages, particularly those meant to inform best health practices in the time of a pandemic.

Background Dengue is the fastest spreading viral infection. A number of epidemics have occurred in subtropical and tropical regions of the United States. A future expansion and intensification of dengue has been predicted, partly due to changing environmental conditions. In the absence of treatment, prevention and control are vital to addressing this vector-borne disease. Health education and community engagement are a key part of such efforts. Given that the majority of Americans search for health information online, ensuring the readability of web-based dengue information is an important consideration for health officials. To date, there is a dearth of information on this topic. Methods To address this gap, "Dengue fever" was searched using Google Chrome to generate a sample of 100 websites. Using Readable.io, the readability of these 100 sites was then determined using five different tests. The data were analyzed using SPSS. Results The results indicate that the vast majority of online materials on dengue are written at a level far beyond what is recommended. Three of the five tests did not find any of the sampled sites to be appropriate in terms of readability. In general, the websites analyzed tended to be written at a level beyond the 10th grade. Conclusion These findings have important implications for future dengue outbreaks in the United States.

BACKGROUND Social media platforms that are based on the creation of visual media, such as TikTok, are increasingly popular with adolescents. Online social media networks provide valuable opportunities to connect with each other to share experiences and strategies for health and wellness. OBJECTIVE The aim of this study was to describe the content of the hashtag #mentalhealth on TikTok. METHODS This cross-sectional, descriptive content analysis study included 100 videos with the hashtag #mentalhealth on TikTok. All videos that included the hashtag #mentalhealth were analyzed and coded for the presence of content categories. Additionally, the comments to each video were viewed and coded for content in the following themes: offering support or validation; mentioning experience with suicide or suicidal ideation; mentioning experience with self-harm; describing an experience with hospitalization for mental health issues; describing other mental health issues; and sharing coping strategies, experiences of healing, or ways to feel better. RESULTS Collectively, the 100 videos studied received 1,354,100,000 views; 266,900,000 likes; and 2,515,954 comments. On average, each video received 13,406,930.69 (SD 8,728,095.52) views; 2,657,425.74 (SD 1,449,920.45) likes; and 24,910.44 (SD 21,035.06) comments. The only content category observed in most (51/100, 51%) of the videos included in the sample was “general mental health.” The remaining content categories appeared in less than 50% of the sample. In total, 32% (32/100) of the videos sampled received more than the overall average number of likes (ie, more that 2.67 million likes). Among these 32 videos, 23 (72%) included comments offering support or validation and 20 (62%) included comments that described other mental health issues or struggles. CONCLUSIONS With over 1 billion cumulative views, almost half of the assessed TikTok videos included in this study reported or expressed symptoms of mental distress. Future research should focus on the potential role of intervention by health care professionals on social media.

The purpose of this paper is to identify demographic differences in U.S. adults’ value of sustainably produced foods and explore how marketing influences self-reported purchasing behavior. A second...

Celiac disease (CD) is an autoimmune condition characterized by an intolerance to dietary gluten for those with a genetic predisposition. The Internet has become a key source of information about C...

There is a dearth of information on the use of Instagram by celiac disease patients. To address this gap, a convenience sample of 150 posts was first coded as personal stories, support syst...

To explore the degree and predictors of and barriers to school garden integration (termed success).A 30-item online survey consisting of demographic, garden characteristic, and barrier questions, as well as the School Garden Integration Scale, was conducted in 266 school garden organizations (13 national, 8 regional, and 245 state or local).A total of 414 school gardeners from 38 states and Puerto Rico.School garden success using the GREEN Tool.Descriptive statistics were used to determine the degree of success of school garden programs and explore barriers. Multiple regression analysis was conducted to determine independent predictors of school garden success.The average score was 37 (range 1-53, of a possible 57 points), indicating moderate success. Operating budget (P.001), operating time (P.05), and planting in-ground (P.01) had a positive significant influence on success score, whereas rural location (P.01) and lacking community interest (P.01) had a negative significant influence, controlling for race/ethnicity, region, total garden investment, and Community Need Index score (a proxy for socioeconomic status).Results indicate that success of school garden programs may be more difficult for the schools located in a rural area or in the absence of school or community-at-large interest. This study found that race/ethnicity of students and socioeconomic status are not related to success score, which is promising as other research indicates that successful school gardens may be especially impactful for low-income people of color. Causal research is needed to identify strategies that increase school garden success, with a focus on engaging key stakeholders (administrators, teachers, parents, the community at large, and garden coordinators).

Background Influenza (flu) is pervasive and burdensome. The purpose of this study was to determine the readability levels of online articles related to flu. Methods Using the search term “influenza,” the URL's of the first 100 English language Web sites were vetted for content to ascertain that the article met inclusion criteria. Five recommended readability tests were conducted using an online service to calculate readability. Overall, the analysis indicates that flu material found on the web is not being written at a level that is widely readable. Results None of the 100 sites included in the analysis received an acceptable score on all 5 assessments. One-sample independent t tests (α = 0.05, df = 99) indicated that it is highly unlikely that flu Web sites are being written at the desirable level. Of the 100 sampled sites, 33 had a .com, 29 had a .org, and 22 had a .gov extension. Extension type did not play a role in readability level of these sites. Conclusions When creating content for the masses, health professionals should maximize their efforts by testing the readability as well as other factors that influence the likelihood that it will be understood.

BACKGROUND During a time of high stress and decreased social interaction, nurses have turned to social media platforms like TikTok as an outlet for expression, entertainment, and communication. OBJECTIVE The purpose of this cross-sectional content analysis study is to describe the content of videos with the hashtag #covidnurse on TikTok, which included 100 videos in the English language. METHODS At the time of the study, this hashtag had 116.9 million views. Each video was coded for content-related to what nurses encountered and were feeling during the COVID-19 pandemic. RESULTS Combined, the 100 videos sampled received 47,056,700 views; 76,856 comments; and 5,996,676 likes. There were 4 content categories that appeared in a majority (>50) of the videos: 83 showed the individual as a nurse, 72 showed the individual in professional attire, 58 mentioned/suggested stress, 55 used music, and 53 mentioned/suggested frustration. Those that mentioned stress and those that mentioned frustration received less than 50% of the total views (n=21,726,800, 46.17% and n=16,326,300, 34.69%, respectively). Although not a majority, 49 of the 100 videos mentioned the importance of nursing. These videos garnered 37.41% (n=17,606,000) of the total views, 34.82% (n=26,759) of the total comments, and 23.85% (n=1,430,213) of the total likes. So, despite nearly half of the total videos mentioning how important nurses are, these videos received less than half of the total views, comments, and likes. CONCLUSIONS Social media and increasingly video-related online messaging such as TikTok are important platforms for social networking, social support, entertainment, and education on diverse topics, including health in general and COVID-19 specifically. This presents an opportunity for future research to assess the utility of the TikTok platform for meaningful engagement and health communication on important public health issues.

Background Despite the public health importance of vaping and the widespread use of TikTok by adolescents and young adults, research is lacking on the nature and scope of vaping content on this networking service. Objective The purpose of this study is to describe the content of TikTok videos related to vaping. Methods By searching the hashtag #vaping in the discover feature, ~478.4 million views were seen during the time of data collection. The first 100 relevant videos under that hashtag were used in this study. Relevance was determined by simply noting if the video was related in any way to vaping. Coding consisted of several categories directly related to vaping and additional categories, including the number of likes, comments, and views, and if the video involved music, humor, or dance. Results The 100 videos included in the sample garnered 156,331,347 views; 20,335,800 likes; and 296,460 comments. The majority of the videos (n=59) used music and over one-third (n=37) used humor. The only content category observed in the majority of the videos sampled was the promotion of vaping, which was included in 57 videos that garnered over 74 million views (47.5% of cumulative views). A total of 42% (n=42) of the 100 videos sampled featured someone vaping or in the presence of vape pens, and these videos garnered over 22% (>35 million) of the total views. Conclusions It is necessary for public health agencies to improve understanding of the nature and content of videos that attract viewers’ attention and harness the strength of this communication channel to promote informed decision-making about vaping.

Current day youth have an important role in climate activism, as the decisions and policies made now will have long lasting impacts on the climate and sustainability. Climate change is becoming an increasing concern for younger generations. As such, the purpose of this study was to describe content related to climate change on TikTok. This study included 100 English-language videos related to climate change featured on TikTok. The hashtag #climatechange was chosen because it had the most views of any related hashtag at the time of the study. The number of views, comments, and likes were recorded for each video. Each video was also observed for the presence of predetermined content characteristics. The 100 videos sampled collectively received 205,551,200 views, 40, 203,400 likes, and 666,089 comments. Only eight of the 100 videos included information from a reputable source. Only three of the characteristics were featured in a majority (> 50) of the videos. These were, presents climate change as real (93), affected populations (76), and climate anxiety/frustration (57). Videos mentioning natural disasters garnered 63,453,100 (30.87%) views, 14,245,200 (35.43%) likes, and 236,493 (35.50%) comments. In all, 73 of the 100 videos mentioned at least one environmental impact. Videos including this theme earned 156,677,200 (76.22%) views, 32,000,700 (79.60%) likes, and 563,195 (84.55%) comments. Social media platforms such as TikTok are important tools for understanding popular opinion regarding public health issues such as global climate change. However, the presence of credible professionals is essential on platforms such as TikTok to increase the chances that messaging is as comprehensive as time allows, while also being scientifically sound.

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Background COVID-19 testing remains an essential element of a comprehensive strategy for community mitigation. Social media is a popular source of information about health, including COVID-19 and testing information. One of the most popular communication channels used by adolescents and young adults who search for health information is TikTok—an emerging social media platform. Objective The purpose of this study was to describe TikTok videos related to COVID-19 testing. Methods The hashtag #covidtesting was searched, and the first 100 videos were included in the study sample. At the time the sample was drawn, these 100 videos garnered more than 50% of the views for all videos cataloged under the hashtag #covidtesting. The content characteristics that were coded included mentions, displays, or suggestions of anxiety, COVID-19 symptoms, quarantine, types of tests, results of test, and disgust/unpleasantness. Additional data that were coded included the number and percentage of views, likes, and comments and the use of music, dance, and humor. Results The 100 videos garnered more than 103 million views; 111,000 comments; and over 12.8 million likes. Even though only 44 videos mentioned or suggested disgust/unpleasantness and 44 mentioned or suggested anxiety, those that portrayed tests as disgusting/unpleasant garnered over 70% of the total cumulative number of views (73,479,400/103,071,900, 71.29%) and likes (9,354,691/12,872,505, 72.67%), and those that mentioned or suggested anxiety attracted about 60% of the total cumulative number of views (61,423,500/103,071,900, 59.59%) and more than 8 million likes (8,339,598/12,872,505, 64.79%). Independent one-tailed t tests (α=.05) revealed that videos that mentioned or suggested that COVID-19 testing was disgusting/unpleasant were associated with receiving a higher number of views and likes. Conclusions Our finding of an association between TikTok videos that mentioned or suggested that COVID-19 tests were disgusting/unpleasant and these videos’ propensity to garner views and likes is of concern. There is a need for public health agencies to recognize and address connotations of COVID-19 testing on social media.

COVID-19 testing remains an essential element of a comprehensive strategy for community mitigation. Social media is a popular source of information about health, including COVID-19 and testing information. One of the most popular communication channels used by adolescents and young adults who search for health information is TikTok-an emerging social media platform.The purpose of this study was to describe TikTok videos related to COVID-19 testing.The hashtag #covidtesting was searched, and the first 100 videos were included in the study sample. At the time the sample was drawn, these 100 videos garnered more than 50% of the views for all videos cataloged under the hashtag #covidtesting. The content characteristics that were coded included mentions, displays, or suggestions of anxiety, COVID-19 symptoms, quarantine, types of tests, results of test, and disgust/unpleasantness. Additional data that were coded included the number and percentage of views, likes, and comments and the use of music, dance, and humor.The 100 videos garnered more than 103 million views; 111,000 comments; and over 12.8 million likes. Even though only 44 videos mentioned or suggested disgust/unpleasantness and 44 mentioned or suggested anxiety, those that portrayed tests as disgusting/unpleasant garnered over 70% of the total cumulative number of views (73,479,400/103,071,900, 71.29%) and likes (9,354,691/12,872,505, 72.67%), and those that mentioned or suggested anxiety attracted about 60% of the total cumulative number of views (61,423,500/103,071,900, 59.59%) and more than 8 million likes (8,339,598/12,872,505, 64.79%). Independent one-tailed t tests (α=.05) revealed that videos that mentioned or suggested that COVID-19 testing was disgusting/unpleasant were associated with receiving a higher number of views and likes.Our finding of an association between TikTok videos that mentioned or suggested that COVID-19 tests were disgusting/unpleasant and these videos' propensity to garner views and likes is of concern. There is a need for public health agencies to recognize and address connotations of COVID-19 testing on social media.

BACKGROUND Despite the public health importance of vaping and the widespread use of TikTok by adolescents and young adults, research is lacking on the nature and scope of vaping content on this networking service. OBJECTIVE The purpose of this study is to describe the content of TikTok videos related to vaping. METHODS By searching the hashtag #vaping in the discover feature, ~478.4 million views were seen during the time of data collection. The first 100 relevant videos under that hashtag were used in this study. Relevance was determined by simply noting if the video was related in any way to vaping. Coding consisted of several categories directly related to vaping and additional categories, including the number of likes, comments, and views, and if the video involved music, humor, or dance. RESULTS The 100 videos included in the sample garnered 156,331,347 views; 20,335,800 likes; and 296,460 comments. The majority of the videos (n=59) used music and over one-third (n=37) used humor. The only content category observed in the majority of the videos sampled was the promotion of vaping, which was included in 57 videos that garnered over 74 million views (47.5% of cumulative views). A total of 42% (n=42) of the 100 videos sampled featured someone vaping or in the presence of vape pens, and these videos garnered over 22% (>35 million) of the total views. CONCLUSIONS It is necessary for public health agencies to improve understanding of the nature and content of videos that attract viewers’ attention and harness the strength of this communication channel to promote informed decision-making about vaping.

Background: The media plays as an important role in delivering information about emergent issues, such as the Eastern equine encephalitis virus (EEEV) outbreak of 2019. As such, there has been an increase in news coverage of vector-borne disease coverage due to a rise in emerging or re-emerging arboviruses. Methods: The purpose of this study was to describe the content of news clips related to the recent (2019) EEEV outbreak in the United States. Results: Only 3 of the important topics identified were mentioned in a majority of the 110 videos analyzed. These topics were, mosquito mentioned as transmitter, prevention by repellent/ pesticide, and geography. Thus, many aspects of EEEV were lacking in coverage. Conclusion: A priority for public health professionals should be to engage in discourse with news media to assure that information disseminated via news channels is not vague or misleading.

Clostridium difficile (C. diff) is a bacterium that causes diarrhea and kills an estimated 29,000 people per year (over one-half of which is directly attributable to C. diff). The objective...

Let G be a finitely generated Fuchsian group of the first kind and let (g : m 1, m 2, …, mn ) be its shortened signature. Beardon showed that almost every Dirichlet region for G has 12g + 4n − 6 sides. Points in ℍ corresponding to Dirichlet regions for G with fewer sides are called exceptional for G. We generalize previously established methods to show that, for any such G, its set of exceptional points is uncountable.

Background: Web-based patient education literature has been shown to be written at reading levels far above what is recommended. Little is known about the overall readability of current internet-based bariatric surgery information. The purpose of this study was to assess the readability of current bariatric material on the internet. Methods: The term "weight loss surgery" was searched using the Chrome browser on the first 15pages of URLs that appeared with content written in English. Using five readability measures, scores were generated using Readable.io for written content on a sample of 96 websites. Scores were sorted into the readability categories of "easy," "average," and "difficult." Results: Almost 93% of websites, both .com and .org, sampled received an unacceptable readability score on each assessment. Conclusion: Accurate and appropriate information about bariatric procedures is critical for patient comprehension and adherence to recommended protocols.

Despite the fact that the internet is a popular source of health information, limited research has been conducted on the ways in which direct-to-consumer (DTC) DNA testing has been discussed by consumers on the internet, and on social media platforms specifically. The purpose of this study was to describe the content of 100 videos that addressed DTC DNA testing on TikTok, a video-sharing social network. The 100 videos included had a combined 77,498 comments and 9,680,309 likes.The majority (> 50%) of videos reviewed mentioned using DTC DNA testing kits to find family roots (94%), included information on commercial DNA testing kits (67%), and featured a person taking or talking about taking a DNA test (92%). These videos also received a majority of the total comments/likes. Neither the use of music (p = .06 and p = .07) nor the mention of using DNA testing to locate family (p = .08 and p = .09) had a significant effect on a video’s comments or likes, respectively. Genetic counselors, health care providers, and public health professionals should be aware that there is a need to present both benefits and disadvantages of DTC DNA testing on social media platforms. A greater presence of comprehensive information on social media platforms can increase the likelihood that one makes erudite decisions.

BACKGROUND The majority of American adults search for health and illness information on the internet. However, the quality and accuracy of this information are notoriously variable. With the advent of social media, US individuals have increasingly shared their own health and illness experiences, including those related to bariatric surgery, on social media platforms. Previous research has found that peer-to-peer requesting and giving of advice related to bariatric surgery on social media is common, that such advice is often presented in stark terms, and that the advice may not reflect patient standards of care. These previous investigations have helped to map bariatric surgery content on Facebook and YouTube. OBJECTIVE This objective of this study was to document and compare weight loss surgery (WLS)–related content on Instagram in the months leading up to the COVID-19 pandemic and 1 year later. METHODS We analyzed a total of 300 Instagram posts (50 posts per week for 3 consecutive weeks in late February and early March in both 2020 and 2021) uploaded using the hashtag #wls. Descriptive statistics were reported, and independent 1-tailed chi-square tests were used to determine if a post’s publication year statistically affected its inclusion of a particular type of content. RESULTS Overall, advice giving and personal responsibility for outcomes were emphasized by WLS posters on Instagram. However, social support was less emphasized. The safety, challenges, and risks associated with WLS were rarely discussed. The majority of posts did not contain references to facts from reputable medical sources. Posts published in 2021 were more likely to mention stress/hardships of living with WLS (45/150, 30%, vs 29/150, 19.3%; P=.03); however, those published in 2020 more often identified the importance of ongoing support for WLS success (35/150, 23.3%, vs 16/150, 10.7%; P=.004). CONCLUSIONS Given that bariatric patients have low rates of postoperative follow-up, yet post-operative care and yet support are associated with improved health and weight loss outcomes, and given that health content on the web is of mixed accuracy, bariatric professionals may wish to consider including an online support forum moderated by a professional as a routine part of postoperative care. Doing so may not only improve follow-up rates but may offer providers the opportunity to counter inaccuracies encountered on social media.

BACKGROUND The tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males. OBJECTIVE The purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic. METHODS Using two popular hashtags, #momjuice and #winemom, 50 Instagram posts on each were collected from the “top posts” tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol. RESULTS Overall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (>50%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed t test demonstrated this difference to be statistically significant (P=.0499). CONCLUSIONS The findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care.

BACKGROUND Over the past decade, there has been an increasing secular trend in the number of studies on social media and health. OBJECTIVE The purpose of this cross-sectional study was to examine the content and characteristics of TikTok videos that are related to an important aspect of community mitigation—the use of masks as a method for interrupting the transmission of SARS-CoV-2. METHODS In total, 100 trending videos with the hashtag #WearAMask (ie, a campaign on TikTok), along with 32 videos that were posted by the World Health Organization (WHO) and involved masks in any way (ie, all related WHO videos at the time of this study), were included in our sample. We collected the metadata of each post, and created content categories based on fact sheets that were provided by the WHO and the US Centers for Disease Control and Prevention. We used these fact sheets to code the characteristics of mask use. RESULTS Videos that were posted on TikTok and had the hashtag #WearAMask garnered almost 500 million views, and videos that were posted by the WHO garnered almost 57 million views. Although the ratio of the number of trending #WearAMask videos to the number of WHO videos was around 3:1, the #WearAMask videos received almost 10 times as many cumulative views as the WHO videos. In total, 68% (68/100) of the trending #WearAMask videos involved humor and garnered over 355 million cumulative views. However, only 9% (3/32) of the WHO videos involved humor. Furthermore, 27% (27/100) of the trending #WearAMask videos involved dance and garnered over 130 million cumulative views, whereas none of the WHO videos involved dance. CONCLUSIONS This study is one of the first to describe how TikTok is being used to mitigate the community spread of COVID-19 by promoting mask use. Due to the platform’s incredible reach, TikTok has great potential in conveying important public health messages to various segments of the population.

College counseling centers are assumed to play a vital role in addressing students' mental health needs during the COVID-19 pandemic. The aim of this study was to characterize the extent to which NYC metropolitan area school websites communicated to students their updated mental health service offerings, psychoeducational information related to COVID-19, and community-based resources after the abrupt end to on-campus services during the Spring semester. A total of 138 websites were analyzed. Overall, only half of the surveyed web pages provided information about remote counseling, and just under two thirds of schools (57.97%) had directions for students experiencing a mental health emergency. As predicted, enrollment size was associated with whether psychoeducation about mental health and COVID-19 and information about remote counseling were available on a school's website. In both cases, medium-sized schools were the most likely to have these resources available on their websites as compared to small and large-sized schools. College counseling center web pages should include robust and current information that targets schools' diverse student bodies.

Objectives The key to reducing mortality from skin cancer depends on early detection and treatment, which, in many cases, means a patient should be informed and possess the self-efficacy necessary to seek expert opinion. The purpose of this study was to determine the readability of skin cancer materials on the Internet using the commonly used readability tests. Study design This is a cross-sectional study. Methods A search was conducted using the key words ‘skin cancer.’ The first 15 pages of websites that contained English language articles on skin cancer comprised the sample for this study. All English language articles appearing on these websites were analyzed using the Readable.io service to automate popular readability scores. For each article, it was determined if it was generated from a .org, .com, .gov, .net, .edu or other source. Five readability tests were conducted on the materials to determine the ease with which one can read each article. Results Of the 102 websites sampled, none received an acceptable score on all five assessments. In fact, more than 90% of the websites sampled received an unacceptable score on any one of the five assessments, and more than 78% of the websites sampled received an unacceptable level on all five assessments. All five readability assessments demonstrated statistically significant results; each P- value obtained from the t -tests was substantially below 0.01 and, hence, below the α = 0.05 threshold. These results indicate that it is unlikely that skin cancer websites are being written at the recommended level. Of the websites sampled, roughly 42% were .com, and slightly more than 36% were .org. Statistical evidence indicated that neither .com nor .org websites are likely to be written at the acceptable level. Conclusions Both for-profit and non-profit agencies which aim to provide health information to consumers should be mindful of the readability levels of the materials they disperse.

Background The tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males. Objective The purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic. Methods Using two popular hashtags, #momjuice and #winemom, 50 Instagram posts on each were collected from the “top posts” tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol. Results Overall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (>50%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed t test demonstrated this difference to be statistically significant (P=.0499). Conclusions The findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care.

The purpose of this study was to determine the readability of 100 articles posted on the Internet related to the Zika virus. An on-line readability calculator was used to generate scores on each website from 5 readability tests. Most of the material analyzed was written at a level beyond grade 10. The data in this study make a compelling case that websites containing information on the Zika virus are being written at levels beyond what is recommended. It would behoove those who create health information to consider ways to adapt their materials in a way that is consistent with recommended readability levels.

Background Over the past decade, there has been an increasing secular trend in the number of studies on social media and health. Objective The purpose of this cross-sectional study was to examine the content and characteristics of TikTok videos that are related to an important aspect of community mitigation—the use of masks as a method for interrupting the transmission of SARS-CoV-2. Methods In total, 100 trending videos with the hashtag #WearAMask (ie, a campaign on TikTok), along with 32 videos that were posted by the World Health Organization (WHO) and involved masks in any way (ie, all related WHO videos at the time of this study), were included in our sample. We collected the metadata of each post, and created content categories based on fact sheets that were provided by the WHO and the US Centers for Disease Control and Prevention. We used these fact sheets to code the characteristics of mask use. Results Videos that were posted on TikTok and had the hashtag #WearAMask garnered almost 500 million views, and videos that were posted by the WHO garnered almost 57 million views. Although the ratio of the number of trending #WearAMask videos to the number of WHO videos was around 3:1, the #WearAMask videos received almost 10 times as many cumulative views as the WHO videos. In total, 68% (68/100) of the trending #WearAMask videos involved humor and garnered over 355 million cumulative views. However, only 9% (3/32) of the WHO videos involved humor. Furthermore, 27% (27/100) of the trending #WearAMask videos involved dance and garnered over 130 million cumulative views, whereas none of the WHO videos involved dance. Conclusions This study is one of the first to describe how TikTok is being used to mitigate the community spread of COVID-19 by promoting mask use. Due to the platform’s incredible reach, TikTok has great potential in conveying important public health messages to various segments of the population.