Vitiligo Health Education: A Study of Accuracy and Engagement of Online Educational Materials

June 2021 | Volume 20 | Issue 6 | Original Article | 623 | Copyright © June 2021


Published online May 26, 2021

Charlotte Read MBBS BSca,b,*, Kevin K. Wu MDc,*, Paulina M. Young MDd, April W. Armstrong MD MPHa

aDepartment of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, CA
bDepartment of Medicine, Imperial College London, London, UK
cDepartment of Medicine, University of California, Irvine, Orange, CA
dDepartment of Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
*Dr. Read and Dr. Wu should be considered joint first author

Abstract
Introduction: Many vitiligo patients seek healthcare information online. However, the accuracy and quality of this information is unknown.
Objective: To determine the accuracy, quality, viewer engagement, and viewer experience of vitiligo videos on social media.
Methods: We searched the term “vitiligo” on YouTube. Videos were stratified based on source categories. Video accuracy was assessed using DAS and ANDI. Video quality was assessed using GQS. Viewer experience was assessed using AVA.
Results: Sixty videos were evaluated for inclusion and exclusion criteria. We evaluated 49 videos with a total of 28.2 million views, 431,416 likes, and 61,976 comments. Of these videos, 27 (55%) were from healthcare sources, and 22 (45%) were from non-healthcare sources. When compared to videos from non-healthcare sources, videos from healthcare sources had significantly higher accuracy scores (ANDI = 3.69 ± 0.16 vs 2.77 ± 0.36; P=0.017 and DAS = 3.72 ± 0.13 vs 3.07 ± 0.28; P=0.029) but significantly fewer views (38,883 vs 1,231,947; P=0.005). Videos from alternative medicine sources had the lowest accuracy scores when compared to the remainder of the videos (ANDI = 0.5 ± 0.13 vs 3.66 ± 0.14; P<0.001 and DAS = 1.25 ± 0.11 vs 3.73 ± 0.11; P<0.001).
Conclusion: Inaccurate videos on vitiligo are prevalent on social media. Misinformation can lead to potentially harmful interventions and delay in seeking evidence-based care. Videos from healthcare sources were more accurate but were viewed less than those from non-healthcare sources. Further efforts are needed to improve the visibility and viewer experience of accurate healthcare content on social media.

J Drugs Dermatol. 2021;20(6):623-629. doi:10.36849/JDD.5835

INTRODUCTION

Vitiligo is a chronic autoimmune disorder affecting an estimated 0.5–2% of the worldwide population.1 It is characterized by the loss of pigmentation of the skin and overlying hair due to the loss of functioning melanocytes in disease-involved areas.2 Although an in-depth understanding of the pathophysiology of vitiligo is under continued investigation, an autoimmune process results in the destruction of melanocytes of the skin.2 Vitiligo has been associated with mental health comorbidities such as low self-esteem,3 depression, anxiety, and hospitalization for mental health disorders4,5 and autoimmune comorbidities such as type I diabetes mellitus6 and autoimmune thyroid disease.7

Nearly half of vitiligo patients are diagnosed prior to the age of 20.8 Teenagers and young adults in these age groups are highly proficient in accessing online information through social media platforms. Among these platforms, YouTube is most popular in these age groups.9 Eight out of ten social media users in the U.S. report having searched for health-related topics on social media.10 Although social media platforms such as YouTube are often used to obtain health information, there are currently no regulatory bodies monitoring these videos for accuracy.

There is a critical knowledge gap in assessing the information of YouTube videos on vitiligo. It is important to evaluate the information presented in these videos because YouTube videos form an important resource for patients to learn about their condition outside of a clinician’s office. In this study, we aim to assess the accuracy, quality, and viewer experience of YouTube videos on vitiligo.

MATERIALS AND METHODS

Search Strategy and Video Inclusion
We searched “vitiligo” on YouTube on August 11th, 2020 without