Improving knowledge of hair loss disorders: Assessing the efficacy of a dermatologist-developed social media video library for patient education

To the Editor: As many as 42% of Americans report utilizing social media to access health information.1Social media “likes” healthcare: From marketing to social business. 2012:40.https://adindex.ru/files2/access/2013_06/99606_tpc-health-care-social-media-report.pdfDate accessed: October 10, 2017Google Scholar Despite this trend, a minority of dermatology-related social media posts are produced by board-certified dermatologists.2Park J.H. Christman M.P. Linos E. Rieder E.A. Dermatology on Instagram: an analysis of hashtags.J Drugs Dermatol. 2018; 17: 482-484PubMed Google Scholar During clinical encounters, dermatologists regularly rely on verbal instruction or educational text to convey complex information to patients.3Olayiwola O. Lazovich D. Wipf A. et al.The use of the video, "dear 16-year-old me," as a melanoma education tool in ambulatory dermatology.Dermatol Surg. 2021; 47: 1551-1555Crossref PubMed Scopus (1) Google Scholar However, through the production of high-quality, publicly available online learning tools, dermatologists have the opportunity to improve continued access to and retention of health information. The purpose of this study is to investigate the efficacy of an online social media video library for improving patient knowledge of hair loss disorders. We conducted a pre-test/post-test intervention study to assess changes in patients’ knowledge of hair disorders after viewing online educational material. Patients were identified during a clinical visit with an alopecia specialist at NYU Langone Health and randomized to watch a brief video on hair cycle physiology, topical minoxidil application, or platelet-rich plasma (PRP) therapy. Videos were made accessible to patients via Instagram through NYU’s ‘SkinScreen’ video library. This study was approved by NYU Langone Health’s Institutional Review Board. Data analyses were conducted using SPSS Statistical Software 28.0 (IBM Corp). Frequencies were calculated to describe the percentage of participants who correctly responded to multiple-choice quiz items before and after watching the educational videos. The McNemar χ2 test was used to compare the proportions of participants who provided correct responses prior to watching the videos versus after watching the videos. Paired samples t tests were used to compare prevideo and postvideo cumulative scores. We enrolled 100 patients, of which 90 (90%) completed the study (Table I). Participants were randomized to watch videos on the hair cycle (N = 29), PRP (N = 32), and topical minoxidil (N = 29). Eleven participants had already viewed their assigned video at a prior clinical visit; these participants’ prevideo scores were significantly higher than the prevideo scores of participants who had no prior exposure to the material (76% vs 29%; P = 0.029).Table IParticipant characteristicsVariableNo., % (n = 90)Sex, female Male18 (20.0%) Female72 (80.0%)Age <3018 (20.0%) 31-4016 (17.8%) 41-5021 (23.3%) 51-6015 (16.7%) 61-7013 (14.4%) 70+7 (7.8%)Highest level of education completed High school1 (1.1%) Some college2 (2.2%) 2-y college2 (2.2%) 4-y college29 (32.2%) Graduate school55 (61.1%) Other1 (1.1%)Alopecia diagnosis Androgenetic alopecia52 (57.8%) Alopecia areata10 (11.1%) Lichen planopilaris7 (7.8%) Frontal fibrosing alopecia11 (12.2%) Telogen effluvium9 (10.0%) Central centrifugal cicatricial alopecia3 (3.3%) Other9 (10.0%)Treatments prior to study participation Topical minoxidil59 (65.6%) Platelet-rich plasma18 (20.0%)Time elapsed between previously viewing video and participating in the study Not applicable: never previously seen video79 (87.8%) 1 mo7 (7.8%) 6 mo1 (1.1%) 1 y3 (3.3%) Open table in a new tab Gains were observed in knowledge on all topics. Viewing any of the videos resulted in a significant increase in participants’ cumulative survey score (Table II). There was only a single question, regarding hair shedding with PRP, for which there was no statistically significant difference in the proportion of participants who responded correctly prior to watching the video versus after watching the video. Eighty-seven percent of respondents described the videos as helpful, and 74% indicated that they would share the video with a friend who wanted to learn more about hair loss.Table IIChange in patient knowledge of hair cycle physiology and hair loss treatmentsHair cycle videoVariableNo. correct responsePrevideo (n = 29)Postvideo (n = 29)P valueQuantity of hair shed each day1126<.001Anagen, definition1224.002Catagen, definition1626.013Telogen, definition1125<.001Time elapsed between a triggering event and telogen effluvium1728<.001Cumulative score, % correct46%89%<.001Platelet-rich plasma videoVariablePrevideo (n = 32)Postvideo (n = 32)P valueQuantity of blood drawn for PRP2531.031Number of injections performed during PRP procedure421<.001Adverse effects of PRP1124<.001Hair shedding with PRP∗Hair shedding with PRP was the only topic tested for which there was no statistically significant difference in the proportion of participants who responded correctly prior to watching the video versus after watching the video. This may be explained in part by the large proportion of participants (23/32) who correctly answered the question before watching the video.2325.727Preparation before PRP procedure1322.022Cumulative score, % correct48%77%<.001Topical minoxidil application videoVariablePrevideo (n = 29)Postvideo (n = 29)P valueQuantity of minoxidil used during single application927<.001Frequency of application2129<.001Utility of massage to spread solution2529<.001Rules regarding hair styling following minoxidil application921<.001Cumulative score, % correct55%91%<.001Bolded for statistical significance, ie, P value <.05.PRP, Platelet-rich plasma.∗ Hair shedding with PRP was the only topic tested for which there was no statistically significant difference in the proportion of participants who responded correctly prior to watching the video versus after watching the video. This may be explained in part by the large proportion of participants (23/32) who correctly answered the question before watching the video. Open table in a new tab Bolded for statistical significance, ie, P value <.05. PRP, Platelet-rich plasma. Social media can transform the way dermatologists communicate with patients. Our results demonstrate video-based educational content is an effective tool for conveying dermatologic health information, supporting the findings of similar studies, which have shown the efficacy of videos for teaching patients about melanoma and skin examinations.3Olayiwola O. Lazovich D. Wipf A. et al.The use of the video, "dear 16-year-old me," as a melanoma education tool in ambulatory dermatology.Dermatol Surg. 2021; 47: 1551-1555Crossref PubMed Scopus (1) Google Scholar,4Janda M. Youl P. Neale R. et al.Clinical skin examination outcomes after a video-based behavioral intervention: analysis from a randomized clinical trial.JAMA Dermatol. 2014; 150: 372-379https://doi.org/10.1001/jamadermatol.2013.9313Crossref PubMed Scopus (27) Google Scholar The significantly higher baseline scores of participants who had viewed the SkinScreen videos at a prior clinical visit suggest that knowledge gains from video viewership may be sustained over time. Study limitations include its small sample size and lack of a control group. Dr Shapiro is a consultant for Aclaris Therapeutics, Incyte, and Replicel Life Sciences. Drs. Shapiro and Lo Sicco have been investigators for Regen Lab and are investigators for Pfizer. Dr Sukhdeo, Dr Svigos, Dr Yin, Dr Peterson, Dr Gutierrez, Elizabeth Klein, and Maria Karim have no conflicts to declare. This manuscript would not have been possible without the contributions of Lilliana Lyons, creative director and editor of the SkinScreen video library.