All Publications

  • Longitudinal remote monitoring of hidradenitis suppurativa: a pilot study. The British journal of dermatology Fonjungo, F. E., Barnes, L. A., Cai, Z. R., Naik, H. B., Eid, E. S., Aleshin, M. A., Nava, V., Johnson, T., Chren, M., Linos, E. 2023

    View details for DOI 10.1093/bjd/ljad385

    View details for PubMedID 37823362

  • Development of a digital tool for home-based monitoring of skin disease for older adults. Skin health and disease van Egmond, S., Cai, Z. R., Nava, V., Joy de Vere Hunt, I., Rapaport, B. R., Ko, J., Chiou, A. S., Sarin, K., Tang, J., Zhang, L., Linos, E. 2023; 3 (5): e235


    We developed a digital tool for home-based monitoring of skin disease, our digital tool. In the current observational pilot study, we found that DORA is feasible to use in practice, as it has a high patient compliance, retention and satisfaction. Clinicans rated the photos generally good quality or perfect quality. These results show that the digital health tool DORA can easily be used by patients to send photos to their dermatologist, which could reduce unnecessary clinical visits. It may also be used in other settings where digital literacy barriers and unequal access to dermatologists contribute to healthcare disparities.

    View details for DOI 10.1002/ski2.235

    View details for PubMedID 37799368

    View details for PubMedCentralID PMC10549824

  • A Social Media-Based Public Health Campaign to Reduce Indoor Tanning in High-Risk Populations. AJPM focus de Vere Hunt, I., Cai, Z. R., Nava, V., Admassu, N. E., Bousheri, S., Johnson, T., Tomz, A., Thompson, J., Zhang, L., Pagoto, S., Wehner, M. R., Mathur, M. B., Linos, E. 2023; 2 (3): None


    Indoor tanning beds cause more than 450,000 new skin cancers each year, yet their use remains common, with a global indoor tanning prevalence of 10.4%. Social media provides an opportunity for cost-effective, targeted public health messaging. We sought to direct Instagram users at high risk of indoor tanning to accurate health information about the risks of indoor tanning and to reduce indoor tanning bed use.We disseminated a public health campaign on Instagram on April 6-27, 2022 with 34 video and still-image advertisements. We had 2 target audiences at high risk of indoor tanning: women aged 18-30 years in Kentucky, Nebraska, Ohio, or Tennessee interested in indoor tanning and men aged 18-45 years in California interested in indoor tanning. To evaluate the impact of the campaign, we tracked online metrics, including website visits, and conducted an interrupted time-series analysis of foot traffic data in our target states for all tanning salons documented on SafeGraph from January 1, 2018 to 3 months after the campaign.Our indoor tanning health information advertisements appeared on Instagram feeds 9.1 million times, reaching 1.06 million individuals. We received 7,004 views of our indoor tanning health information landing page (Average Time on Page of 56 seconds). We did not identify a significant impact on foot traffic data on tanning salons.We show the successful use of social media advertising to direct high-risk groups to online health information about indoor tanning. Future research quantifying tanning visits before and after indoor tanning interventions is needed to guide future public health efforts.

    View details for DOI 10.1016/j.focus.2023.100123

    View details for PubMedID 37662553

    View details for PubMedCentralID PMC10465716

  • Qualitative exploration of melanoma awareness in black people in the USA. BMJ open de Vere Hunt, I., Owen, S., Amuzie, A., Nava, V., Tomz, A., Barnes, L., Robinson, J. K., Lester, J., Swetter, S., Linos, E. 2023; 13 (1): e066967


    Although black patients are more likely to have advanced melanomas at diagnosis, with a 5-year survival rate among black patients of 70% compared with 92% for white patients, black people are generally not the focus of melanoma public health campaigns. We sought to explore awareness and perspectives of melanoma among black people to inform the development of relevant and valued public health messages to promote early detection of melanoma.Inductive thematic analysis of in-depth semistructured interviews.Interviews were conducted with participants via video software or telephone in the USA.Participants were adults from the USA who self-identified as African American or black. Recruitment flyers were posted around the San Francisco Bay Area and shared on our team Facebook page, with further participants identified through snowball sampling.We interviewed 26 participants from 10 different states. Overall, 12 were men and 14 were women, with a mean age of 43 years (range 18-85). We identified five key themes regarding melanoma awareness in black people: (1) lack of understanding of term 'melanoma' and features of skin cancer; (2) do not feel at risk of melanoma skin cancer; (3) surprise that melanoma can occur on palms, soles and nails; (4) skin cancer awareness messages do not apply to or include black people; and (5) Importance of relationship with healthcare and habits of utilisation.Analysis of these in-depth semistructured interviews illuminate the pressing need for health information on melanoma designed specifically for black people. We highlight two key points for focused public health messaging: (1) melanoma skin cancer does occur in black people and (2) high-risk sites for melanoma in black people include the palms, soles and nail beds. Therefore, public health messages for black people and their healthcare providers may involve productively checking these body surface areas.

    View details for DOI 10.1136/bmjopen-2022-066967

    View details for PubMedID 36631232

    View details for PubMedCentralID PMC9835941

  • Gender Differences in National Institutes of Health Grant Submissions Before and During the COVID-19 Pandemic. Journal of women's health (2002) Roubinov, D., Haack, L. M., Folk, J. B., Rotenstein, L., Accurso, E. C., Dahiya, P., Ponce, A. N., Nava, V., Maldonado, Y., Linos, E., Mangurian, C. 2022; 31 (9): 1241-1245


    Introduction: Emerging data suggest that the COVID-19 pandemic has disproportionately impacted women in academic medicine, potentially eliminating recent gains that have been made toward gender equity. This study examined possible pandemic-related gender disparities in research grant submissions, one of the most important criteria for academic promotion and tenure evaluations. Methods: Data were collected from two major academic institutions (one private and one public) on the gender and academic rank of faculty principal investigators who submitted new grants to the National Institutes of Health (NIH) during COVID-19 (March 1st, 2020, through August 31, 2020) compared with a matched period in 2019 (March 1st, 2019, through August 31, 2019). t-Tests and chi-square analyses compared the gender distribution of individuals who submitted grants during the two periods of examination. Results: In 2019 (prepandemic), there was no significant difference in the average number of grants submitted by women compared with men faculty. In contrast, women faculty submitted significantly fewer grants in 2020 (during the pandemic) than men. Men were also significantly more likely than women to submit grants in both 2019 and 2020 compared with submitting in 2019 only, suggesting men faculty may have been more likely than their women colleagues to sustain their productivity in grant submissions during the pandemic. Discussion: Women's loss of extramural funding may compound over time, as it impedes new data collection, research progress, and academic advancement. Efforts to support women's research productivity and career trajectories are urgently needed in the following years of pandemic recovery.

    View details for DOI 10.1089/jwh.2022.0182

    View details for PubMedID 36112424

  • A Social Media‒Based Public Health Campaign Encouraging COVID-19 Vaccination Across the United States. American journal of public health Hunt, I. d., Dunn, T., Mahoney, M., Chen, M., Nava, V., Linos, E. 2022: e1-e4


    Tailored public health messaging encouraging COVID-19 vaccination may help increase vaccination rates and decrease the burden of COVID-19. We conducted a three-part COVID-19 vaccine uptake public health campaign disseminated on Facebook between April and June 2021. Our first campaign focused on reaching Black and Latinx communities; our second campaign focused on addressing vaccine access and scheduling in Latinx communities; and our third campaign focused on religious communities. Overall, we reached 25 million individuals with 171 million views across the United States. (Am J Public Health. Published online ahead of print July 7, 2022:e1-e4.

    View details for DOI 10.2105/AJPH.2022.306934

    View details for PubMedID 35797502

  • Barriers and facilitators to mobile health and active surveillance use among older adults with skin disease. Health expectations : an international journal of public participation in health care and health policy Johnson, A., Shukla, N., Halley, M., Nava, V., Budaraju, J., Zhang, L., Linos, E. 2021


    BACKGROUND: The COVID-19 pandemic has accelerated the adoption of telemedicine, including teledermatology. Monitoring skin lesions using teledermatology may become increasingly important for several skin diseases, including low-risk skin cancers. The purpose of this study was to describe the key factors that could serve as barriers or facilitators to skin disease monitoring using mobile health technology (mHealth) in older adults.METHODS: Older adult dermatology patients 65years or older and their caregivers who have seen a dermatologist in the last 18months were interviewed and surveyed between December 2019 and July 2020. The purpose of these interviews was to better understand attitudes, beliefs and behaviours that could serve as barriers and facilitators to the use of mHealth and active surveillance to monitor low-risk skin cancers.RESULTS: A total of 33 interviews leading to 6022 unique excerpts yielded 8 factors, or themes, that could serve as barriers, facilitators or both to mHealth and active surveillance. We propose an integrated conceptual framework that highlights the interaction of these themes at both the patient and provider level, including care environment, support systems and personal values.DISCUSSION AND CONCLUSIONS: These preliminary findings reveal factors influencing patient acceptance of active surveillance in dermatology, such as changes to the patient-provider interaction and alignment with personal values. These factors were also found to influence adoption of mHealth interventions. Given such overlap, it is essential to address barriers and facilitators from both domains when designing a new dermatology active surveillance approach with novel mHealth technology.PATIENT OR PUBLIC CONTRIBUTION: The patients included in this study were participants during the data collection process. Members of the Stanford Healthcare and Denver Tech Dermatology health-care teams aided in the recruitment phase of the data collection process.

    View details for DOI 10.1111/hex.13229

    View details for PubMedID 34190397

  • Telehealth for Older Adults with Skin Disease: A Qualitative Exploration of Dermatologists' Experiences & Recommendations for Improving Care. The British journal of dermatology de Vere Hunt, I., van Egmond, S., Nava, V., Khodosh, R., Lester, J., Chiou, A. S., Linos, E. 2021


    The COVID-19 pandemic accelerated the use of telehealth, defined as the delivery of health care via remote technologies1 , with widespread adoption of live-interactive video visits across the US.2 3 4 Yet, it is important to avoid exacerbating healthcare disparities for vulnerable populations such as older adults, who traditionally have more technological literacy barriers.5 6 Our aim was to explore dermatologists' experiences of using telehealth with older adults, in order to identify and summarise recommendations to improve telehealth care.

    View details for DOI 10.1111/bjd.20891

    View details for PubMedID 34773643

  • US Public Concerns About the COVID-19 Pandemic From Results of a Survey Given via Social Media. JAMA internal medicine Nelson, L. M., Simard, J. F., Oluyomi, A. n., Nava, V. n., Rosas, L. G., Bondy, M. n., Linos, E. n. 2020

    View details for DOI 10.1001/jamainternmed.2020.1369

    View details for PubMedID 32259192