UPJ INSIGHT Health Care Workers YouTube Content Compared to AUA Prevention of Recurrent UTIs in Women Guideline

By: Mostafa Bondok, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Lynn Stothers, MD, MHSc, David Geffen School of Medicine at the University of California, Los Angeles; Andrew Macnab, MD, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Mohamed Bondok, BEng, Cumming School of Medicine, University of Calgary, Alberta, Canada; A. Lenore Ackerman, MD, PhD, David Geffen School of Medicine at the University of California, Los Angeles; Emma Dixon, College of Medicine, California Northstate University, Elk Grove; Marcia Trochez, School of Medicine, University of California, Riverside; Kelsey Petersen, Faculty of Science, University of British Columbia, Vancouver, Canada; Rishika Selvakumar, BSc, Faculty of Science, University of British Columbia, Vancouver, Canada | Posted on: 20 May 2024

Bondok M, Stothers L, Macnab A, et al. Health care workers online YouTube content compared to AUA prevention of recurrent urinary tract infections in women guidelines: an integrative review of quality and comprehensiveness analysis. Urol Pract. 2024;11(3):498-505. doi:10.1097/UPJ.0000000000000537

Study Need and Importance

The majority of web users use the internet as a primary source to obtain health-related information to both empower their decisions and support conversations with their health care providers. Prevention and treatment of recurrent UTIs (rUTIs) in women remain one of the most common reasons women seek information to guide care. This study documented the quality, veracity, and comprehensiveness of rUTI information from YouTube to raise health care workers’ (HCWs’) awareness of content, to identify deficits in patient understanding, and to clarify misconceptions. High-traffic topic search terms in Google Trends were used to identify videos which were evaluated by independent reviewers using a standardized questionnaire and compared to the evidence-based AUA rUTI guidelines.

What We Found

The basic definition described to patients online was incongruent or incomplete based on guideline UTI definitions in 78% of videos, this despite 80% being provided by HCWs. Nonguideline-based hygiene practices were promoted in 42%. Negative descriptors used by the hosts were identified; these included the mention of women with UTI as being “unclean” stigmatizing women with rUTI. Only 55% of videos discussed increasing fluid intake, and 33% discussed the use of cranberry supplementation (Table).

Table. Summary of Video Descriptive Characteristics

Characteristic	Data
Video duration, mean (range), min:s Views, mean (range)	5:12 (0:44-29:02) 376,771 (10,931-4,496,798)
Date published, No. videos (%) Before September 1, 2019 After September 1, 2019	24 (53) 21 (47)
Main narrator, No. videos (%) Health care worker Health advocacy group News outlet host Unclear or not applicable	36 (80) 1 (2.2) 3 (6.7) 5 (11)
Main purpose, No. videos (%) Education on UTIs Advertisement/promotion of a product or brand Other	45 (100) 0 (0) 0 (0)
Marketing, No. videos (%) A specific nonantibiotic product or treatment Advertisement, other than a UTI-related product Treatment alternatives to antibiotics incorrectly stated or exaggerated Viewers are encouraged to not use antibiotics, when indicated None of the above	0 (0) 4 (8.9) 0 (0) 0 (0) 41 (91)

Limitations

There are inevitable limitations when evaluating YouTube which we made efforts to control for; eg, YouTube lacks controlled vocabulary. Also, only English videos were evaluated, resulting in 7 of 200 sourced videos being excluded.

Interpretation for Patient Care

Videos included prominent discussion of hygiene practices outside of AUA guideline statements. Importantly for HCWs any characterization of women with rUTI as unclean creates a health equity concern. Our detailed findings should alert HCWs to the scope and emphasis in online materials that patients may view to self-educate; both the errors and the issues of equity are problematic.