In the United States, African Americans (AAs) have been disproportionately affected by COVID-19 mortality. However, AAs are more likely to be hesitant in receiving COVID-19 vaccinations when compared to non-Hispanic Whites. We examined factors associated with vaccine hesitancy among a predominant AA community sample. We performed a cross-sectional analysis on data collected from a convenience sample of 257 community-dwelling participants in the Central Savannah River Area from 5 December 2020, through 17 April 2021. Vaccine hesitancy was categorized as resistant, hesitant, and acceptant. We estimated relative odds of vaccine resistance and vaccine hesitancy using polytomous logistic regression models. Nearly one-third of the participants were either hesitant (n = 40, 15.6%) or resistant (n = 42, 16.3%) to receiving a COVID-19 vaccination. Vaccine-resistant participants were more likely to be younger and were more likely to have experienced housing insecurity due to COVID-19 when compared to both acceptant and hesitant participants, respectively. Age accounted for nearly 25% of the variation in vaccine resistance, with 21-fold increased odds (OR: 21.93, 95% CI: 8.97–5.26–91.43) of vaccine resistance in participants aged 18 to 29 compared to 50 and older adults. Housing insecurity accounted for 8% of the variation in vaccine resistance and was associated with 7-fold increased odds of vaccine resistance (AOR: 7.35, 95% CI: 1.99–27.10). In this sample, AAs under the age of 30 and those experiencing housing insecurity because of the COVID-19 pandemic were more likely to be resistant to receiving a free COVID-19 vaccination.

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Sports-related concussions occur with high incidence in the United States. Google Trends™ (GT) analyses indicate changes of public interest in a topic over time, and can be correlated with incidence of health events such as concussion. Internet searches represent a primary means of patient education for many health topics, including concussion; however, the quality of medical information yielded by internet searches is variable and frequently of an inappropriate reading level. This study therefore aims to describe GT over time and evaluate the quality and readability of information produced by Google™ searches of the term “concussion.” We identified a strong negative correlation from 2009 to 2016 between GT scores and total number of American high school football participants ( R 2 = 0.8553) and participants per school ( R 2 = 0.9533). Between 2004 and 2020, the monthly GT popularity score were variable ( p = 3.193E-08), with September having the greatest scores, correlating with the height of American tackle football season. Applying five validated quality assessment scoring systems at two time points, it was confirmed that different sources yielded varying quality of information. Academic and non-profit healthcare sources demonstrated the highest quality metrics across two time points. There was significant variability of scores among the different scoring systems, however. The majority of searches at both time points yielded information that was rated as “fair” to “poor” in quality. Applying six readability tests, we revealed that only a single commercial website offered information written at or below the American Medical Association– recommended 6th-grade level for healthcare information. In summary, GT data analyses suggest that searches correlate with the American tackle football season and increased between 2009 and 2016, given that public interest in concussion increased and annual participation in football decreased. The quality of information yielded by Google™ searches and readability are inadequate, indicating the need for significant improvement.

ObjectiveThis investigation employs 2004–2020 Google Trends data to correlate concussion search popularity and high school sports participation while assessing search seasonality and factors associated with search escalation.BackgroundEvents linked to concussions, from news to entertainment, altered public perception of concussions and discouraged high-risk activities. Such sentiment likely promoted high school football's 2004–2018 8% decrease in participation, despite simultaneous 8% increase for sports overall. Google Trends (GT) analysis calculates distinct subjects' popularity scores (0–100) by normalizing Google search frequency with other subjects in the same topic. With 35% of patients researching their conditions using Google, tracking concussion popularity scores allows robust analysis of event-driven fluctuation, seasonal variation, and sports impact.Design/MethodsWorldwide GT analysis was conducted for the disease topic “Concussion” with the categorical filter “Health” from 2004 to 2020. This period's monthly popularity scores with annual averages and annual high school sports participation data were subsequently obtained from Google Trends and the National Federation of State High School Associations, respectively.ResultsConcurrence of significant score changes with CTE studies' publication, release of 2015 film Concussion, and the COVID-19 pandemic validates GT's measurement of public interest. From 2006 to 2016, Pearson's correlation coefficients demonstrated strong negative correlation between GT popularity scores for “Concussion” with total number of high school football participants overall (R2 = 0.8553) and participants per school (R2 = 0.9533). Confirming football-related seasonality, one-way ANOVA regression analysis concluded 2004–2020's mean change in month-specific popularity score is not the same (p = 3.193E-08), and months during football season had statistically significant variability (September: p = 4.389E-05) with elevated average z-scores.ConclusionsCoupled with ANOVA regression and normalized analyses, strong negative correlations between concussion popularity score and high school football participation produce quantitative measures of a long-suspected relationship. Tracking concussion popularity and seasonality with Google Trends provides insight into how, when, and why patients are educating themselves online.

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