Use of digital technologies in public health: a narrative review

Paolo Castiglia; Marco Dettori; Antonella Arghittu; Guglielmo Campus; Danila  De Vito

doi:10.23750/abm.v94iS3.14589

Use of digital technologies in public health: a narrative review

Authors

Paolo Castiglia Department of Medicine, Surgery and Pharmacy, University of Sassari
Marco Dettori Department of Medicine, Surgery and Pharmacy, University of Sassari https://orcid.org/0000-0002-4901-2067
Antonella Arghittu Department of Medicine, Surgery and Pharmacy, University of Sassari https://orcid.org/0000-0001-9257-1422
Guglielmo Campus Department of Restorative, Preventive and Pediatric Dentistry, University of Bern
Danila De Vito Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari https://orcid.org/0000-0002-4816-4456

Keywords:

Digital Technologies, Digital Health, Health Literacy, Self-management education

Abstract

Background and aim: Websites, social media networks and mobile applications constitute important communication tools, while simultaneously enabling the population to increase their knowledge of health issues. This study aims to describe digital health experiences in Public Health to examine the different possible uses of digital technologies by Public Health Operators (PHOs) and Health Care Workers (HCWs) and the role these tools play in the efficiency of the health interventions undertaken. Methods: A narrative literature survey was conducted by consulting the PubMed and Scopus databases to find articles relevant to the topic of interest. The selection criteria adopted for manuscript screening involved including the survey studies dealing with the use of digital means such as new media in Public Health, published between 1 January 2012 and 31 May 2021.

Results: Based on the keywords, 2,019 manuscripts were identified, of which 45 were included. The articles were grouped according to the digital tool (social media network, mobile application and websites) employed by PHOs and/or HCWs in health promotion initiatives. Specifically, this was broken down into: i) the use of social media in public health: 24 articles, ii) the use of mobile applications: 10 articles, iii) the use of websites: 8 articles and iv) the use of the three digital tools combined: 3 articles.

Conclusions: The results of this study indicate that digital technologies may play a useful role in Public Health to improve communication between health professionals and patients, provide quality care even remotely and facilitate the achievement of health outcomes for the population from a Health Literacy perspective.

References

Kim H, Goldsmith JV, Sengupta S, et al. Mobile Health Application and e-Health Literacy: Opportunities and Concerns for Cancer Patients and Caregivers. J Cancer Educ. 2019 Feb;34(1):3-8. doi: 10.1007/s13187-017-1293-5

World Health Organization guideline: recommendations on digital interventions for health system strengthening. Geneva: World Health Organization; 2019.

Research 2 Guidance. mHealth Developer Economics Connectivity in Digital Health. The largest research program on mHealth app publishing Report. Available online: mHealth Economics 2017/2018 – Connectivity in Digital Healthresearch2guidance.com https://research2guidance.com (accessed on 15 Feb 2023).

Jandoo T. WHO guidance for digital health: What it means for researchers. Digit Health. 2020 Jan 8;6:2055207619898984. doi: 10.1177/2055207619898984

Vidal-Alaball J, Acosta-Roja R, Pastor Hernández N, et al. Telemedicine in the face of the COVID-19 pandemic. Aten Primaria. 2020 Jun-Jul; 52(6):418-422. doi: 10.1016/j.aprim.2020.04.003

Nahavandi S. Industry 5.0—A Human-Centric Solution. Sustainability 2019, 11, 4371. doi: 10.3390/su11

Arghittu A, Deiana G, Castiglia E, et al. Knowledge, Attitudes, and Behaviors towards Proper Nutrition and Lifestyles in Italian Diabetic Patients during the COVID-19 Pandemic. Int J Environ Res Public Health. 2022 Sep 7;19(18):11212. doi: 10.3390/ijerph191811212

Meininger L, Adam J, VWirth E, et al. Cognitive-behavioral teletherapy for children and adolescents with mental disorders and their families during the COVID-19 pandemic: a survey on acceptance and satisfaction. Child Adolesc Psychiatry Ment Health. 2022 Jul 28.

Hilty D, Chan S, Torous J, Luo J, Boland R. A Framework for Competencies for the Use of Mobile Technologies in Psychiatry and Medicine: Scoping Review. JMIR Mhealth Uhealth. 2020 Feb 21;8(2):e12229. doi: 10.2196

/12229

Mohr DC, Burns MN, Schueller SM, Clarke G, Klinkman M. Behavioral intervention technologies: evidence review and recommendations for future research in mental health. Gen Hosp Psychiatry. 2013 Jul-Aug;35(4):332-8. doi: 10.1016/j.genhosppsych.2013.03.008

Kapoor KK, Tamilmani K, Rana NP, Patil PP, Dwivedi YK, Nerur S. Advances in Social Media Research: Past, Present and Future. Inf. Syst. Front. 2018;20:531–538. doi: 10.1007/s10796-017-9810-y.

González-Padilla DA, Tortolero-Blanco L. Social media influence in the COVID-19 Pandemic. Int Braz J Urol. 2020 Jul;46(suppl.1):120-124. doi: 10.1590/S1677-5538.IBJU.2020.S121

Vaterlaus JM, Aylward A, Tarabochia D, Martin JD. “A smartphone made my life easier”: An exploratory study on age of adolescent Smartphone acquisition and well-being. Comput. Hum. Behav. 2021; 114:106563. doi: 10.1016/j

.chb.2020.106563

Levitz N, Wood E, Kantor L. The Influence of Technology Delivery Mode on Intervention Outcomes: Analysis of a Theory-Based Sexual Health Program. J Med Internet Res. 2018;20(8):e10398. doi: 10.2196/10398

World Health Organization Managing the COVID-19 Infodemic: Promoting Healthy Behaviours and Mitigating the Harm from Mi-sinformation and Disinformation. Available online: https://www.who.int/news/item/23-09-2020

-managing-the-covid-19-infodemic-promoting-healthy

-behaviours-and-mitigating-the-harm-from-misinformation

-and-disinformation (accessd on 20 Feb 2023)

Global Overview Report. Digital 2023: essential headlines. Available online: https://datareportal.com/reports/digital

-2023-global-overview-report (accessed on 22 Feb 2023)

Boccalini S, Bonanni P, Chiesi F, et al. The Experience of VaccinarSinToscana Website and the Role of New Media in Promoting Vaccination. Vaccines (Basel). 2020 Nov 3;8(4):644. doi: 10.3390/vaccines8040644.

Dettori M, Castiglia P. COVID-19 and Digital Health: Evolution, Perspectives and Opportunities. Int J Environ Res Public Health. 2022 Jul 12;19(14):8519. doi: 10.3390

/ijerph19148519

Castiglia P, Arghittu A. New Insight in Vaccination and Public Health: A Commentary from Special Issue Editors. Vaccines. 2022;10:183. doi: 10.3390/vaccines10020183

World Health Organization. mHealth Use of appropriate digital technologies for public health. Available online: https://apps.who.int/gb/ebwha/pdf_files/WHA71

/A71_20-en.pdf. (accessed on 13 Feb 2023)

Odone A, Buttigieg S, Ricciardi W, Azzopardi-Muscat N, Staines A. Public health digitalization in Europe. Eur J Public Health. 2019 Oct 1;29(Supplement_3):28-35. doi: 10.1093/eurpub/ckz161. Erratum in: Eur J Public Health. 2021 Dec 1;31(6):e1

Materia FT, Faasse K, Smyth JM. Understanding and Preventing Health Concerns About Emerging Mobile Health Technologies. JMIR Mhealth Uhealth. 2020 May 25;8(5):e14375. doi: 10.2196/14375

Liao CY, Liu WI. Current Status and Prospects for Information Communication Technology (ICT) in Allied Health Education. Hu Li Za Zhi. 2020;67:6–11. doi: 10.6224

/JN.202010_67(5).02

Arghittu A, Deiana G, Dettori M, et al. Web-based analysis on the role of Digital Media in Health Communication: The Experience of VaccinarSinSardegna Website. Acta Biomed. 2021;92:e2021456. doi: 10.23750/abm.v92iS6.12072

Oelhafen S, Trachsel M, Monteverde S, Raio L, Cignacco E. Informal coercion during childbirth: risk factors and prevalence estimates from a nationwide survey of women in Switzerland. BMC Pregnancy Childbirth. 2021 May 10;21(1):369. doi: 10.1186/s12884-021-03826-1. Erratum in: BMC Pregnancy Childbirth. 2021 Jun 22;21(1):437

Z Wang, Z Yin e YA Argyris, “Detecting Medical Misinformation on Social Media Using Multimodal Deep Learning”, in IEEE Journal of Biomedical and Health Informatics, vol. 25, n. 6, pp. 2193-2203, giugno 2021, doi: 10.1109

/JBHI.2020.3037027

Scheffers F, Moonen X, VVugt E. Assessing the quality of support and discovering sources of resilience during COVID-19 measures in people with intellectual disabilities by professional carers. Res Dev Disabil. 2021 Apr;111:103889

. doi: 10.1016/j.ridd.2021.103889

Giustina A, Legg E, Cesana BM, et al. Results from ACROCOVID: an international survey on the care of acromegaly during the COVID-19 era. Endocrine 71, 273–280 (2021). doi: 10.1007/s12020-020-02565-

Lane ECA, Tran AA, Graulty CJ, Bumsted T. Rapid Mobilization of Medical Students to Provide Health Care Workers With Emergency Childcare During the COVID-19 Pandemic. Acad Med. 2021 Sep 1;96(9):1302-1305. doi: 10.1097/ACM.0000000000004115

Karim N, Jing L, Lee JA, et al. Lessons Learned from Rwanda: Innovative Strategies for Prevention and Containment of COVID-19. Ann Glob Health. 2021 Feb 25;87(1):23. doi: 10.5334/aogh.3172

Cleal B, Willaing I, Hoybye MT, Thomsen HH. Facebook as a Medium for the Support and Enhancement of Ambulatory Care for People With Diabetes: Qualitative Realist Evaluation of a Real-World Trial. JMIR Diabetes. 2020 Sep 14;5(3):e18146. doi: 10.2196/18146

Mallett AJ, Quinlan C, Patel C, et al. Precision Medicine Diagnostics for Rare Kidney Disease: Twitter as a Tool in Clinical Genomic Translation. Kidney Med. 2019 Aug 14;1(5):315-318. doi: 10.1016/j.xkme.2019.06.006. Erratum in: Kidney Med. 2020 Jan 06;2(1):94

Probst YC, Peng Q. Social media in dietetics: Insights into use and user networks. Nutr Diet. 2019 Sep;76(4):414-420. doi: 10.1111/1747-0080.12488

Hazzam J, Lahrech A. Health Care Professionals’ Social Media Behavior and the Underlying Factors of Social Media Adoption and Use: Quantitative Study. J Med Internet Res. 2018 Nov 7;20(11):e12035. doi: 10.2196/12035

Starmann E, Heise L, Kyegombe N, et al. Examining diffusion to understand the how of SASA!, a violence against women and HIV prevention intervention in Uganda. BMC Public Health. 2018 May 11;18(1):616. doi: 10.1186

/s12889-018-5508-4

Clyne W, Pezaro S, Deeny K, Kneafsey R. Using Social Media to Generate and Collect Primary Data: The #ShowsWorkplaceCompassion Twitter Research Campaign. JMIR Public Health Surveill. 2018 Apr 23;4(2):e41. doi: 10.2196

/publichealth.7686

Tucker I, & Goodings L. (2018). Medicated bodies: Mental distress, social media and affect. New Media & Society, 20(2), 549–563. doi: 10.1177/1461444816664347

Sanguansak T, Morley KE, Morley MG, Thinkhamrop K, Thuanman J, Agarwal I. Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study. J Med Internet Res. 2017 Dec 19;19(12):e413. doi: 10.2196/jmir.8330

Petrovski G, Zivkovic M. Impact of Facebook on Glucose Control in Type 1 Diabetes: A Three-Year Cohort Study. JMIR Diabetes. 2017 Jun 7;2(1):e9. doi: 10.2196

/diabetes.7693

Grosberg D, Grinvald H, Reuveni H, Magnezi R. Frequent Surfing on Social Health Networks is Associated With Increased Knowledge and Patient Health Activation. J Med Internet Res. 2016 Aug 10;18(8):e212. doi: 10.2196

/jmir.5832

Van de Belt TH, Engelen LJ, Berben SA, Teerenstra S, Samsom M, Schoonhoven L. Internet and social media for health-related information and communication in health care: preferences of the Dutch general population. J Med Internet Res. 2013 Oct 2;15(10):e220. doi: 10.2196/jmir.2607

He S, Ojo A, Beckman AL, et al. The Story of #GetMePPE and GetUsPPE.org to Mobilize Health Care Response to COVID-19 : Rapidly Deploying Digital Tools for Better Health Care. J Med Internet Res. 2020 Jul 20;22(7):e20469. doi: 10.2196/20469

Chan WS, Leung AY. Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial. J Med Internet Res. 2020 Jun 2;22(6):e16772. doi: 10.2196/16772

Blackman KCA, Slama DS, Pickering TA, et al. Evaluation of a breastfeeding promotion film among a racially minoritized sample. BMC Pregnancy Childbirth. 2022 Mar 28;22(1):262. doi: 10.1186/s12884-022-04607-0

Xin H, Zhang H, Wang D, et al. The effect of WeChat-based training on improving the knowledge of tuberculosis management of rural doctors. J Clin Tuberc Other Mycobact Dis. 2021 Aug 11;25:100266. doi: 10.1016/j.jctube.2021.100266

Sukriani W, Greiny Arisani. “Effectiveness of whatsapp group on breastfeeding practices.” Indian Journal of Forensic Medicine & Toxicology 14.4 (2020): 3550-3555

Woods J, Moorhouse M, Knight L. A descriptive analysis of the role of a WhatsApp clinical discussion group as a forum for continuing medical education in the management of complicated HIV and TB clinical cases in a group of doctors in the Eastern Cape, South Africa. South Afr J HIV Med. 2019 Aug 1;20(1):982. doi: 10.4102/sajhivmed.v20i1.982

Souza CTV, Santana CS, Ferreira P, Nunes JA, Teixeira MLB, Gouvêa MIFDS. Caring in the age of COVID-19: lessons from science and society. Cad Saude Publica. 2020 Jun 26;36(6):e00115020. Portuguese, English. doi: 10.1590/0102-311X00115020

Ferrucci F, Jorio M, Marci S, et al. Web-Based Application for Complex Health Care Populations: User-Centered Design Approach. JMIR Hum Factors. 2021 Jan 13;8(1):e18587. doi: 10.2196/18587

Chen J, Allman-Farinelli M. Impact of Training and Integration of Apps Into Dietetic Practice on Dietitians’ Self-Efficacy With Using Mobile Health Apps and Patient Satisfaction. JMIR Mhealth Uhealth. 2019 Mar 4;7(3):e12349. doi: 10.2196/12349

Paradis M, Atkinson KM, Hui C, et al. Immunization and technology among newcomers: A needs assessment survey for a vaccine-tracking app. Hum Vaccin Immunother. 2018 Jul 3;14(7):1660-1664. doi: 10.1080/21645515.2018

Gabarron E, Serrano JA, Fernandez-Luque L, Wynn R, Schopf T. Randomized trial of a novel game-based appointment system for a university hospital venereology unit: study protocol. BMC Med Inform Decis Mak. 2015 Apr 8;15:23. doi: 10.1186/s12911-015-0143-9

Parker SM, Stocks N, Nutbeam D, et al. Preventing chronic disease in patients with low health literacy using eHealth and teamwork in primary healthcare: protocol for a cluster randomised controlled trial. BMJ Open. 2018 Jun 4;8(6):e023239. doi: 10.1136/bmjopen-2018-023239

Kotecha D, Chua WWL, Fabritz L, et al. European Society of Cardiology smartphone and tablet applications for patients with atrial fibrillation and their health care providers. Europace. 2018 Feb 1;20(2):225-233. doi: 10.1093

/europace/eux299

Bae YS, Kim KH, Choi SW, et al. Information Technology-Based Management of Clinically Healthy COVID-19 Patients: Lessons From a Living and Treatment Support Center Operated by Seoul National University Hospital. J Med Internet Res. 2020 Jun 12;22(6):e19938. doi: 10.2196/19938

Borgen I, Garnweidner-Holme LM, Jacobsen AF, et al. Smartphone application for women with gestational diabetes mellitus: a study protocol for a multicentre randomised controlled trial. BMJ Open. 2017 Mar 27;7(3):e013117. doi: 10.1136/bmjopen-2016-013117

Oza S, Jazayeri D, Teich JM, et al. Development and Deployment of the OpenMRS-Ebola Electronic Health Record System for an Ebola Treatment Center in Sierra Leone. J Med Internet Res. 2017 Aug 21;19(8):e294. doi: 10.2196/jmir.7881

Ciani O, Cucciniello M, Petracca F, et al. Lung Cancer App (LuCApp) study protocol: a randomised controlled trial to evaluate a mobile supportive care app for patients with metastatic lung cancer. BMJ Open. 2019 Feb 15;9(2):e025483. doi: 10.1136/bmjopen-2018-025483

Dening J, George ES, Ball K, Islam SMS. User-centered development of a digitally-delivered dietary intervention for adults with type 2 diabetes: The T2Diet study. Internet Interv. 2022 Feb 12;28:100505. doi: 10.1016/j.invent.2022

Templeton M, Kelly C, Lohan M. Developing a Sexual Health Promotion Intervention With Young Men in Prisons: A Rights-Based Participatory Approach. JMIR Res Protoc. 2019 Apr 29;8(4):e11829. doi: 10.2196/11829

Mahroum N, Watad A, Rosselli R, et al. An infodemiological investigation of the so-called “Fluad effect” during the 2014/2015 influenza vaccination campaign in Italy: Ethical and historical implications. Hum Vaccin Immunother. 2018 Mar 4;14(3):712-718. doi: 10.1080/21645515.2017.1420448.

Wahedi K, Flores W, Beiersmann C, Bozorgmehr K, Jahn A. Using information communication technology to identify deficits in rural health care: a mixed-methods evaluation from Guatemala. Glob Health Action. 2018;11(1):1455347. doi: 10.1080/16549716.2018.1455347

Porterfield DS, Marcial LH, Brown S, Throop C, Pina J. Evaluation of a Quality Improvement Resource for Public Health Practitioners. Public Health Rep. 2017 Mar

/Apr;132(2):140-148. doi: 10.1177/0033354916689609

Sak G, Diviani N, Allam A, Schulz PJ. Comparing the quality of pro- and anti-vaccination online information: a content analysis of vaccination-related webpages. BMC Public Health. 2016 Jan 15;16:38. doi: 10.1186

/s12889-016-2722-9

Das A, Faxvaag A, Svanµs D. The Impact of an eHealth Portal on Health Care Professionals’ Interaction with Patients: Qualitative Study. J Med Internet Res. 2015 Nov 24;17(11):e267. doi: 10.2196/jmir.4950

Arghittu A, Dettori M, Dempsey E, et al. Health Communication in COVID-19 Era: Experiences from the Italian VaccinarSì Network Websites. Int J Environ Res Public Health. 2021 May 25;18(11):5642. doi: 10.3390

/ijerph18115642

Lindsay S, Gellin B, Lee A, Garrett D. The Coalition Against Typhoid: Mobilizing a Community for a Global Fight. Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S161-S164. doi: 10.1093/cid/ciy1117

Verduci E, Vizzuso S, Frassinetti A, et al. Nutripedia: The Fight against the Fake News in Nutrition during Pregnancy and Early Life. Nutrients. 2021 Aug 28;13(9):2998. doi: 10.3390/nu13092998.

Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. (2005) 8:19–32. 10.1080/1364557032000119616.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71.

Iyamu I, Xu AXT, Gómez-Ramírez O, et al. Defining Digital Public Health and the Role of Digitization, Digitalization, and Digital Transformation: Scoping Review. JMIR Public Health Surveill. 2021 Nov 26;7(11):e30399. doi: 10.2196/30399

World Health Organization (WHO). Draft Global Strategy on Digital Health 2020-2025. 2020. Available online: https://www.who.int/docs/default-source/documents

/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf (accessed on: 31 Gen 2023)

Aiello AE, Renson A, Zivich PN. Social Media- and Internet-Based Disease Surveillance for Public Health. Annu Rev Public Health. 2020 Apr 2;41:101-118. doi: 10.1146

/annurev-publhealth-040119-094402.

Soler-Costa R, Lafarga-Ostáriz P, Mauri-Medrano M, Moreno-Guerrero AJ. Netiquette: Ethic, Education, and Behavior on Internet-A Systematic Literature Review. Int. J. Environ. Res. Public Health. 2021;18:1212. doi: 10.3390

/ijerph18031212

Kwong CKY, Fong BYF. Promotion of appropriate use of electronic devices among Hong Kong adolescents. Asia Pac. J. Health Manag. 2019;14:1–6. doi: 10.24083/apjhm.v14i1.199

Park CS, Kaye BK. Smartphone and self-extension: Functionally, anthropomorphically, and ontologically extending self via the Smartphone. Mob. Media Commun. 2019;7:215–231. doi: 10.1177/2050157918808327

Brewer LC, Fortuna KL, Jones C, et al. Back to the future: achieving health equity through health informatics and digital health. JMIR Mhealth Uhealth. 2020 Jan 14;8(1):

e14512. doi: 10.2196/14512

Eysenbach G. What is e-health? J Med Internet Res. 2001 Apr-Jun;3(2):E20. doi: 10.2196/jmir.3.2.e20

While A. Digital health and technologies. Br J Community Nurs. 2023 Mar 2;28(3):120-126. doi: 10.12968

/bjcn.2023.28.3.120

Frascella B, Oradini-Alacreu A, Balzarini F, Signorelli C, Lopalco PL, Odone A. Effectiveness of email-based reminders to increase vaccine uptake: a systematic review. Vaccine. 2020 Jan 16;38(3):433-443. doi: 10.1016/j.vaccine.2019.10.089.

Zhang L, Li H, Chen K. Effective Risk Communication for Public Health Emergency: Reflection on the COVID-19 (2019-nCoV) Outbreak in Wuhan, China. Healthcare. 2020;8:64. doi: 10.3390/healthcare8010064

Farmer A, Williams V, Velardo C, et al. Self-management support using a digital health system compared with usual care for chronic obstructive pulmonary disease: Randomized controlled trial. J Med Internet Res 2017; 19: e144

Arghittu A, Dettori M, Masia MD, Azara A, Dempsey E, Castiglia P. Social deprivation indexes and anti-influenza vaccination coverage in the elderly in Sardinia, Italy, with a focus on the Sassari municipality. J Prev Med Hyg. 2019 Feb 28;59(4 Suppl 2):E45-E50. doi: 10.15167/2421-4248

/jpmh2018.59.4s2.1077

Dettori M, Pittaluga P, Busonera G, et al. Environmental Risks Perception Among Citizens Living Near Industrial Plants: A Cross-Sectional Study. Int J Environ Res Public Health. 2020 Jul 6;17(13):4870. doi: 10.3390

/ijerph17134870

Parikh RB, Basen-Enquist KM, Bradley C, et al. Digital Health Applications in Oncology: An Opportunity to Seize. J Natl Cancer Inst. 2022 Oct 6;114(10):1338-1339. doi: 10.1093/jnci/djac108

Balletto G, Borruso G, Milesi A, et al. (2021) Sport-City Planning. A Proposal for an Index to Support Decision-Making Practice: Principles and Strategies. In: Gervasi O. et al. (eds) Computational Science and Its Applications –

ICCSA 2021. ICCSA 2021. Lecture Notes in Computer Science, vol 12952. Springer, Cham. doi: 10.1007

/978-3-030-86973-1_18

Ratzan SC, Sommariva S, Rauh L. Enhancing global health communication during a crisis: lessons from the COVID-19 pandemic. Public Health Res Pract. 2020 Jun 30;30(2):3022010. doi: 10.17061/phrp3022010

Rathbone AL, Prescott J. The Use of Mobile Apps and SMS Messaging as Physical and Mental Health Interventions: Systematic Review. J Med Internet Res. 2017 Aug 24;19(8):e295. doi: 10.2196/jmir.7740

Janett RS, Yeracaris PP. Electronic Medical Records in the American Health System: challenges and lessons learned. Cien Saude Colet. 2020 Mar;25(4):1293-1304. doi: 10.1590/1413-81232020254.28922019

Zeraatkar K, Ahmadi M. Trends of infodemiology studies: a scoping review. Health Info Libr J. 2018 Jun;35(2):91-120. doi: 10.1111/hir.12216

Gentili D, Bardin A, Ros E, et al. Impact of Communication Measures Implemented During a School Tuberculosis Outbreak on Risk Perception among Parents and School Staff, Italy, 2019. Int. J. Environ. Res. Public Health. 2020;17:911. doi: 10.3390/ijerph17030911

Bonanni P, Angelillo I, Villani A, et al. Maintain and increase vaccination coverage in children, adolescents, adults and elderly people: Let’s avoid adding epidemics to the pandemic: Appeal from the Board of the Vaccination Calendar for Life in Italy: Main-tain and increase coverage also by re-organizing vaccination services and reassuring the population. Vaccine. 2021;39:1187–1189. doi: 10.1016/j.vaccine.2020.10.024

Dettori M, Arghittu A, Castiglia P. Knowledge and Behaviours towards Immunisation Programmes: Vaccine Hesitancy during the COVID-19 Pandemic Era. Int J Environ Res Public Health. 2022 Apr 5;19(7):4359. doi: 10.3390

/ijerph19074359

Arghittu A, Dettori M, Azara A, et al. Flu Vaccination Attitudes, Behaviours, and Knowledge among Health Workers. Int J Environ Res Public Health. 2020 May 3;17(9):3185. doi: 10.3390/ijerph17093185

Dettori M, Arghittu A, Deiana G, et al. Influenza Vaccination Strategies in Healthcare Workers: A Cohort Study (2018-2021) in an Italian University Hospital. Vaccines (Basel). 2021 Aug 30;9(9):971. doi: 10.3390/vaccines

Odone A, Gianfredi V, Sorbello S, et al. The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts’ Interviews. Vaccines (Basel). 2021 Oct 3;9(10):1126. doi: 10.3390/vaccines9101126.