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Objective: There are concerns about nonscientific and/or unclear information on the coronavirus disease 2019 (COVID-19) that is available on the Internet. Furthermore, people’s ability to understand health information varies and depends on their skills in reading and interpreting information. This study aims to evaluate the readability and creditability of websites with COVID-19-related information.Methods: The search terms “coronavirus,” “COVID,” and “COVID-19” were input into Google. The websites of the first thirty results for each search term were evaluated in terms of their credibility and readability using the Health On the Net Foundation code of conduct (HONcode) and Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Gunning Fog, and Flesch Reading Ease Score (FRE) scales, respectively.Results: The readability of COVID-19-related health information on websites was suitable for high school graduates or college students and, thus, was far above the recommended readability level. Most websites that were examined (87.2%) had not been officially certified by HONcode. There was no significant difference in the readability scores of websites with and without HONcode certification.Conclusion: These results suggest that organizations should improve the readability of their websites and provide information that more people can understand. This could lead to greater health literacy, less health anxiety, and the provision of better preventive information about the disease.

Background An analysis of predictors of smoking behaviour among users of smoking cessation apps can provide useful information beyond what is already known about predictors in other contexts. Therefore, the aim of the present study was to identify the best predictors of smoking cessation, smoking reduction and relapse six months after starting to use the smartphone app Stop-Tabac. Method Secondary analysis of 5293 daily smokers from Switzerland and France who participated in a randomised trial testing the effectiveness of this app in 2020, with follow-up at one and six months. Machine learning algorithms were used to analyse the data. The analyses for smoking cessation included only the 1407 participants who responded after six months; the analysis for smoking reduction included only the 673 smokers at 6-month follow-up; and the analysis for relapse at 6 months included only the 502 individuals who had quit smoking after one month. Results Smoking cessation after 6 months was predicted by the following factors (in this order): tobacco dependence, motivation to quit smoking, frequency of app use and its perceived usefulness, and nicotine medication use. Among those who were still smoking at follow-up, reduction in cigarettes/day was predicted by tobacco dependence, nicotine medication use, frequency of app use and its perceived usefulness, and e-cigarette use. Among those who had quit smoking after one month, relapse after six months was predicted by intention to quit, frequency of app use, perceived usefulness of the app, level of dependence and nicotine medication use. Conclusion Using machine learning algorithms, we identified independent predictors of smoking cessation, smoking reduction and relapse. Studies on the predictors of smoking behavior among users of smoking cessation apps may provide useful insights for the future development of these apps and future experimental studies. Clinical trial registration ISRCTN Registry: ISRCTN11318024, 17 May 2018. http://www.isrctn.com/ISRCTN11318024 .

Objectives: There are presently no data available concerning Internet addiction (IA) problems among adolescents in Canada and the province of Quebec. The goal of this study is thus to document and compare the influence of gender on Internet use and addiction. Method: The study data were collected from a larger research project on gambling among adolescents. Activities conducted online (applications used and time spent) as well as answers to the Internet Addiction Test (IAT) were collected from 3938 adolescents from grades 9 to 11. The two most often employed cut-off points for the IAT in the literature were documented: (40-69 and 70+) and (50+). Results: Boys spent significantly more time on the Internet than did girls. A greater proportion of the girls made intense use of social networks, whereas a greater proportion of the boys made intense use of massively multiplayer online role-playing games, online games, and adult sites. The proportion of adolescents with a potential IA problem varied according to the cut-off employed. When the cut-off was set at 70+, 1.3% of the adolescents were considered to have an IA, while 41.7% were seen to be at risk. At a 50+ cut-off, 18% of the adolescents were considered to have a problem. There was no significant difference between the genders concerning the proportion of adolescents considered to be at risk or presenting IA problems. Finally, analysis of the percentile ranks would seem to show that a cut-off of 50+ better describes the category of young people at risk. Conclusions: The results of this study make it possible to document Internet use and IA in a large number of Quebec adolescents.

Impulsivity is a multifaceted construct that has a prominent role in psychiatry. Lynam et al (2006) have developed the UPPS-P, a 59-item scale measuring 5 impulsivity components: negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking. The aim of the present study was to validate a short, 20-item French version of the UPPS-P. Six hundred fifty participants filled out the short French UPPS-P. A subgroup of participants (n = 145) took part in a follow-up study and completed the scale twice to determine test-retest stability; another subgroup (n = 105) was screened with other questionnaires also to establish external validity. Confirmatory factor analyses supported a hierarchical model comprising 2 higher order factors of urgency (resulting from negative urgency and positive urgency) and lack of conscientiousness (resulting from lack of premeditation and lack of perseverance) as well as a separate factor of sensation seeking. The results indicated good internal consistency and test-retest stability. External validity was supported by relationships with psychopathological symptoms. The short French version of the UPPS-P therefore presents good psychometric properties and may be considered a promising instrument for both research and clinical practice.

Background: Cyberchondria denotes excessive and repeated online health-related searches associated with an increase in health anxiety. Such searches persist in those with cyberchondria, despite the negative consequences, resembling a pattern of compulsive Internet use. Objectives: The aim of the present study was to assess compulsive health-related Internet use in relation to cyberchondria while controlling for related variables. Method: Adult participants (N = 749) were recruited from an online platform. They completed questionnaires assessing the severity of cyberchondria (via the Cyberchondria Severity Scale [CSS]), compulsive Internet use adapted for online health-related seeking (via the adapted Compulsive Internet Use Scale [CIUS]), and levels of intolerance of uncertainty and anxiety, as well as depressive, somatic, and obsessive-compulsive symptoms. A logistic regression analysis was carried out to identify predictors of scores above a cutoff value on the CIUS, indicating compulsive health-related Internet use. Results: The regression output showed that only the CSS total score and sex made a unique, statistically significant contribution to the model, leading to the correct classification of 78.6% of the cases. Of the CSS subscales, compulsion and distress were the most strongly associated with compulsive health-related Internet use. Conclusions: The finding that the adapted CIUS scores are associated with cyberchondria indicates that cyberchondria has a compulsive component, at least in terms of health-related Internet use. It also suggests that compulsive health-related Internet use persists despite the distress associated with this activity. Males may engage in cyberchondria more compulsively than females. These findings have implications for research and clinical practice.

The use of social network sites (SNSs) has grown dramatically. Numerous studies have shown that SNS users may suffer from excessive use, associated with addictive-like symptoms. With a focus on the popular SNS Facebook (FB), our aims in the current study were twofold: First, to explore the heterogeneity of FB usage and determine which kind of FB activity predicts problematic usage; second, to test whether specific impulsivity facets predict problematic use of FB. To this end, a sample of FB users (N = 676) completed an online survey assessing usage preferences (e.g., types of activities performed), symptoms of problematic FB use and impulsivity traits. Results indicated that specific usage preferences (updating one's status, gaming via FB, and using notifications) and impulsive traits (positive and negative urgency, lack of perseverance) are associated to problematic FB use. This study underscores that labels such as FB \"addiction\" are misleading and that focusing on the actual activities performed on SNSs is crucial when considering dysfunctional usage. Furthermore, this study clarified the role of impulsivity in problematic FB use by building on a theoretically driven model of impulsivity that assumes its multidimensional nature. The current findings have identifiable theoretical and public health implications.

Background Impulsivity is involved in numerous psychiatric and addictive disorders, as well as in risky behaviors. The UPPS-P scale highlights five complementary impulsivity constructs (i.e., positive urgency, negative urgency, lack of perseverance, lack of premeditation, and sensation seeking) that possibly work as different pathways linking impulsivity to other disorders. In this study, we aimed to evaluate the psychometric properties of the Arab language short 20-item UPPS-P scale and to eventually validate it. Methods Participants were recruited online through e-mail invitations. After online informed consent was obtained, the questionnaires (the UPPS-P and the Compulsive Internet Use Scale [CIUS]) were completed anonymously. The five dimensions of the Arab UPPS-P model were assessed in a sample of 743 participants. Results As in other linguistic assessments of the UPPS-P, confirmatory factor analysis showed the validity of a model with five different, but nonetheless interrelated, facets of impulsivity. A three-factor model with two higher order factors—urgency (negative and positive) and lack of conscientiousness (lack of premeditation and lack of perseverance)—and a third sensation seeking factor fit the data well, but to a lesser extent. The results suggested good internal consistency, with external validity shown from correlations between some of the UPPS-P components and a measure of addictive Internet use (the CIUS). Conclusion The Arab short UPPS-P is a valid assessment tool with good psychometric properties and is suitable for online use.

We aimed to assess the popularity and perceived effectiveness of smartphone tools that track and limit smartphone use. We also aimed to explore how a set of variables related to mental health, smartphone use, and smartphone addiction may influence the use of these tools. First, we conducted a web-based survey in a representative sample of 1989 US-based adults using the crowdsourcing platform Prolific. Second, we used machine learning and other statistical tools to identify latent user classes; the association between latent class membership and demographic variables; and any predictors of latent class membership from covariates such as daily average smartphone use, social problems from smartphone use, smartphone addiction, and other psychiatric conditions. Smartphone tools that monitor and control smartphone use were popular among participants, including parents targeting their children; for example, over two-thirds of the participants used sleep-related tools. Among those who tried a tool, the highest rate of perceived effectiveness was 33.1% (58/175). Participants who experienced problematic smartphone use were more likely to be younger and more likely to be female. Finally, 3 latent user classes were uncovered: nonusers, effective users, and ineffective users. Android operating system users were more likely to be nonusers, whereas younger adults and females were more likely to be effective users. The presence of psychiatric symptoms did not discourage smartphone tool use. If proven effective, tools that monitor and control smartphone use are likely to be broadly embraced. Our results portend well for the acceptability of mobile interventions in the treatment of smartphone-related psychopathologies and, potentially, non–smartphone-related psychopathologies. Better tools, targeted marketing, and inclusive design, as well as formal efficacy trials, are required to realize their potential.

Background The Health of the Nation Outcome Scale (HoNOS) is a widely used 12-item tool to assess mental health and social functioning. The French version has an added 13th item measuring adherence to psychotropic medication. The aim of the current study is to uncover the unknown pattern of the new item 13 and to compare the unidimensional and multidimensional fit of the new HoNOS-13 using Item Response Theory (IRT). This research question was studied among inpatients with substance use disorder (SUD). Methods Six hundred and nine valid questionnaires of HoNOS-13 were analyzed using unidimensional (one-factor) and multidimensional (two-factor) IRT modeling. Results The multidimensional model suggesting a first factor capturing psychiatric/impairment-related issues and a second factor reflecting social-related issues yielded better goodness-of-fit values compared to the unidimensional solution. This resulted in an improvement of all slope parameters which in turn translates to better discriminative power. Significant improvement in item location parameters were observed as well. The new item 13 had a good discriminative power (1.17) and covered a wide range of the latent trait (− 0.14 to 2.64). Conclusions We were able to validate the 13-item questionnaire including medication compliance and suggest that the HoNOS-13 can be recommended as a clinical evaluation tool to assess the problems and treatment needs for inpatients with SUD. Interestingly, the majority of item response categories are endorsed by respondents who are below and above the average levels of HoNOS. This indicates that the scale is able to discriminate between participants both at the low and at the high ends of the latent trait continuum. More importantly, the new item 13 has a good discriminative power and covers a broad range of the latent trait below and above the mean. It therefore has the desired profile of a good item and is a useful measure for the assessment of mental health and social functioning. Trial registration ClinicalTrials.gov, Identifier: NCT03551301. Registered: 11.06.2018. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03551301 .

Background Smartphone-based support can reach thousands of smokers and help those who would otherwise try to quit smoking by themselves with little chance of success. Nicotine medications double the chances of quitting smoking, but few smokers use them, and they often use them for too short a time and at an insufficient dose. It is therefore important to increase access to support for smoking cessation and compliance with nicotine therapy. The objectives of this study are to assess whether the Stop-Tabac application (app) is effective for smoking cessation and to examine whether the outcome is influenced by the personal characteristics of participants. Methods Trial design: this is a two-arm, parallel-group, superiority, individually randomized, “placebo” controlled trial in 5200 smokers, with follow up after 1 week, 1 month and 6 months. The participants are adult daily smokers ( N  = 5200) enrolled on the Internet, living in France or Switzerland. The intervention is the Stop-tabac fully-automated app for smartphones, which was launched in 2012 and continuously improved thereafter. It includes fact sheets; calculators of cigarettes not smoked, money saved, and years of life gained; an interactive “coach” that provides automated, individually tailored counseling messages based on the user’s personal profile, sent regularly for 6 months; immediate feedback during episodes of craving and tobacco withdrawal symptoms; a discussion forum (“The Tribe”) where participants provide and receive social support; a quiz that informs users in a playful way; and a module on nicotine therapy that includes personalized feedback and follow up. The outcome is self-reported smoking cessation after 6 months (no puff of tobacco in the past 4 weeks), and after 1 week and 1 month (no puff in the past 7 days). Participants will be randomized automatically based on a list of random numbers. Participants, assistants in charge of collecting follow-up data and data analysts will be blinded to allocation. Funding is provided by the Swiss National Science Foundation, CHF 194,942 (EUR 182,200, USD 200,700), grant 32003_179369. JFE’s salary is paid by the University of Geneva, YK’s salary is paid by the Lausanne University Hospitals. Discussion There is little evidence from randomized trials of the impact of health apps in general and of smoking cessation apps in particular. This study will fill this gap. Trial registration ISRCTN Registry: ISRCTN11318024 . Registered on 17 May 2018.