Social Media Engagement and Public Health Communication: Implications for Public Health Organizations Being Truly “Social”

Testing behaviour change with an artificial intelligence chatbot in a randomized controlled study

Chatbots can effect large-scale behaviour change because they are accessible through social media, flexible, scalable, and gather data automatically. Yet research on the feasibility and effectiveness of chatbot-administered behaviour change interventions is sparse. The effectiveness of established behaviour change interventions when implemented in chatbots is not guaranteed, given the unique human-machine interaction dynamics. We pilot-tested chatbot-based behaviour change through information provision and embedded animations. We evaluated whether the chatbot could increase understanding and intentions to adopt protective behaviours during the pandemic. Fifty-nine culturally and linguistically diverse participants received a compassion intervention, an exponential growth intervention, or no intervention. We measured participants' COVID-19 testing intentions and measured their staying-home attitudes before and after their chatbot interaction. We found reduced uncertainty about protective behaviours. The exponential growth intervention increased participants' testing intentions. This study provides preliminary evidence that chatbots can spark behaviour change, with applications in diverse and underrepresented groups.

The Influence of Joe Wicks on Physical Activity During the COVID-19 Pandemic: Thematic, Location, and Social Network Analysis of X Data

BACKGROUND

 Social media (SM) was essential in promoting physical activity during the COVID-19 pandemic, especially among people confined to their homes. Joe Wicks, a fitness coach, became particularly popular on SM during this time, posting daily workouts that millions of people worldwide followed.

OBJECTIVE

 This study aims to investigate the influence of Joe Wicks on SM and the impact of his content on physical activity levels among the public.

METHODS

 We used NodeXL Pro (Social Media Research Foundation) to collect data from X (formerly Twitter) over 54 days (March 23, 2020, to May 15, 2020), corresponding to the strictest lockdowns in the United Kingdom. We collected 290,649 posts, which we analyzed using social network analysis, thematic analysis, time-series analysis, and location analysis.

RESULTS

 We found that there was significant engagement with content generated by Wicks, including reposts, likes, and comments. The most common types of posts were those that contained images, videos, and text of young people (school-aged children) undertaking physical activity by watching content created by Joe Wicks and posts from schools encouraging pupils to engage with the content. Other shared posts included those that encouraged others to join the fitness classes run by Wicks and those that contained general commentary. We also found that Wicks' network of influence was extensive and complex. It contained numerous subcommunities and resembled a broadcast network shape. Other influencers added to engagement with Wicks via their networks. Our results show that influencers can create networks of influence that are exhibited in distinctive ways.

CONCLUSIONS

Our study found that Joe Wicks was a highly influential figure on SM during the COVID-19 pandemic and that his content positively impacted physical activity levels among the public. Our findings suggest that influencers can play an important role in promoting public health and that government officials should consider working with influencers to communicate health messages and promote healthy behaviors. Our study has broader implications beyond the status of fitness influencers. Recognizing the critical role of individuals such as Joe Wicks in terms of health capital should be a critical area of inquiry for governments, public health authorities, and policy makers and mirrors the growing interest in health capital as part of embodied and digital experiences in everyday life.

A conceptional model integrating geographic information systems (GIS) and social media data for disease exposure assessment

Although previous studies have acknowledged the potential of geographic information systems (GIS) and social media data (SMD) in assessment of exposure to various environmental risks, none has presented a simple, effective and user-friendly tool. This study introduces a conceptual model that integrates individual mobility patterns extracted from social media, with the geographic footprints of infectious diseases and other environmental agents utilizing GIS. The efficacy of the model was independently evaluated for selected case studies involving lead in the ground; particulate matter in the air; and an infectious, viral disease (COVID- 19). A graphical user interface (GUI) was developed as the final output of this study. Overall, the evaluation of the model demonstrated feasibility in successfully extracting individual mobility patterns, identifying potential exposure sites and quantifying the frequency and magnitude of exposure. Importantly, the novelty of the developed model lies not merely in its efficiency in integrating GIS and SMD for exposure assessment, but also in considering the practical requirements of health practitioners. Although the conceptual model, developed together with its associated GUI, presents a promising and practical approach to assessment of the exposure to environmental risks discussed here, its applicability, versatility and efficacy extends beyond the case studies presented in this study.

Clearing the air: evaluating institutions' social media health messaging on wildfire and smoke risks in the US Pacific Northwest

BACKGROUND

Wildfire smoke contributes substantially to the global disease burden and is a major cause of air pollution in the US states of Oregon and Washington. Climate change is expected to bring more wildfires to this region. Social media is a popular platform for health promotion and a need exists for effective communication about smoke risks and mitigation measures to educate citizens and safeguard public health.

METHODS

Using a sample of 1,287 Tweets from 2022, we aimed to analyze temporal Tweeting patterns in relation to potential smoke exposure and evaluate and compare institutions' use of social media communication best practices which include (i) encouraging adoption of smoke-protective actions; (ii) leveraging numeric, verbal, and Air Quality Index risk information; and (iii) promoting community-building. Tweets were characterized using keyword searches and the Linguistic Inquiry and Word Count (LIWC) software. Descriptive and inferential statistics were carried out.

RESULTS

44% of Tweets in our sample were authored between January-August 2022, prior to peak wildfire smoke levels, whereas 54% of Tweets were authored during the two-month peak in smoke (September-October). Institutional accounts used Twitter (or X) to encourage the adoption of smoke-related protective actions (82% of Tweets), more than they used it to disseminate wildfire smoke risk information (25%) or promote community-building (47%). Only 10% of Tweets discussed populations vulnerable to wildfire smoke health effects, and 14% mentioned smoke mitigation measures. Tweets from Washington-based accounts used significantly more verbal and numeric risk information to discuss wildfire smoke than Oregon-based accounts (p = 0.042 and p = 0.003, respectively); however, Tweets from Oregon-based accounts on average contained a higher percentage of words associated with community-building language (p < 0.001).

CONCLUSIONS

This research provides practical recommendations for public health practitioners and researchers communicating wildfire smoke risks on social media. As exposures to wildfire smoke rise due to climate change, reducing the environmental disease burden requires health officials to leverage popular communication platforms, distribute necessary health-related messaging rapidly, and get the message right. Timely, evidence-based, and theory-driven messaging is critical for educating and empowering individuals to make informed decisions about protecting themselves from harmful exposures. Thus, proactive and sustained communications about wildfire smoke should be prioritized even during wildfire "off-seasons."

X as a Passive Sensor to Identify Opinion Leaders: A Novel Method for Balancing Visibility and Community Engagement

The identification of opinion leaders is a matter of great significance for companies and authorities, as these individuals are able to shape the opinions and attitudes of entire societies. In this paper, we consider X (formerly Twitter) as a passive sensor to identify opinion leaders. Given the unreliability of the traditional follower count metric due to the presence of fake accounts and farm bots, our approach combines the measures of visibility and community engagement to identify these influential individuals. Through an experimental evaluation involving approximately 4 million tweets, we showed two important findings: (i) relying solely on follower count or post frequency is inadequate for accurately identifying opinion leaders, (ii) opinion leaders are able to build community and gain visibility around specific themes. The results showed the benefits of using X as a passive sensor to identify opinion leaders, as the proposed method offers substantial advantages for those who are involved in social media communication strategies, including political campaigns, brand monitoring, and policymaking.

Social media influencers and adolescents' health: A scoping review of the research field

Social media influencers (SMIs) have become an important source of health information for adolescents. However, the lack of expertise and commercial interests of SMIs pose challenges for adolescent health. To gain a better understanding of these challenges, this scoping review aimed to synthesize existing research on the role of SMIs in adolescent health. Using the PRISMA-ScR approach, we conducted a comprehensive search of eight databases and screened articles based on predefined criteria. The final sample included 51 articles published between 2012 and 2022. Results revealed inconsistent definitions and classifications of SMIs. The most common topics included appearance, nutrition, and substance use, while mental and sexual health topics were underrepresented. The ability of SMIs to establish trustworthy relationships with their followers was highlighted in the reviewed studies, shedding light on potential benefits and challenges for adolescent health. However, most studies focused on the negative roles of SMIs, such as the promotion of unrealistic body images, unhealthy diets, substance use, and inaccurate diagnosis and treatment advice. In addition, inappropriate advertising of unhealthy products (e.g., junk food, tobacco products and alcohol) was identified as a major challenge. The reviewed studies identified stricter regulation and improved social media and health literacy as important avenues for policy action. Less attention was given to the potential positive impact of SMIs and how to effectively include them in health promotion campaigns. In addition, the majority of studies were conducted in the Global North and relied on quantitative approaches, resulting in a lack of representation of minority populations and male adolescents.

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives

This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic.

Study design

A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis?

Methods

Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis.

Results

Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community.

Conclusions

Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues.

"It Frustrates Me Beyond Words That I Can't Fix that": Health Misinformation Correction on Facebook During COVID-19

This study investigated the experiences of communication officials at local health departments (LHD) in the US Midwest regarding the correction of health misinformation on Facebook during the COVID-19 pandemic. Through interviews with communication officials, this study examined how and why they corrected health misinformation, the challenges they encountered during the correction process, and the importance of having fact-checkers within LHDs. The analysis of the data revealed four major themes: factors influencing misinformation correction on Facebook, perceived effectiveness of health misinformation correction, the intersection of the First Amendment and health misinformation, and the role of fact-checking in LHDs. The LHD communication officials often faced conflicts and public rebuttals when directly correcting misinformation leading them to adopt the strategy of addressing misinformation through future posts instead of direct correction. These findings provide significant insights for communication officials to identify and correct health misinformation and emphasize the need for healthcare organizations to provide essential resources to information and communication professionals during times of crises.

How Likes and Retweets Impacted Our Patients During the COVID-19 Pandemic

The growing dependence on social media for health-related information boomed during the COVID-19 pandemic, posing unprecedented challenges in navigating the vast amounts of information available right at our fingertips. Social media had a major impact on clinical decision-making affecting individuals, communities, and societies at large. In this review, we discuss the role of social media in amplifying information and misinformation as well as factors contributing to its reliance and prevalence. We review how medical providers have been impacted by this changing landscape, useful communication strategies to employ with in-office patient encounters, and how we can be active players in using social media as a tool for health promotion, correcting misinformation, and preparing for future pandemics.

Strengthening scientific credibility in the face of misinformation and disinformation: Viable solutions

Despite numerous attempts to mitigate their spread, misinformation and disinformation are rampant on social media and other public networks, posing a substantial risk to public health and individual well-being. A concerted, multi-channel approach is required to effectively tackle this evolving problem. This paper outlines potential strategies and actionable plans to improve the response to misinformation and disinformation by stakeholders from various healthcare ecosystems.

A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review

BACKGROUND

Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal.

OBJECTIVE

This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes.

METHODS

We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects.

RESULTS

We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages.

CONCLUSIONS

Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement."

TRIAL REGISTRATION

PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.

Using AI-ML to Augment the Capabilities of Social Media for Telehealth and Remote Patient Monitoring

Artificial intelligence (AI) and machine learning (ML) have revolutionized the way health organizations approach social media. The sheer volume of data generated through social media can be overwhelming, but AI and ML can help organizations effectively manage this information to improve telehealth, remote patient monitoring, and the well-being of individuals and communities. Previous research has revealed several trends in AI-ML adoption: First, AI can be used to enhance social media marketing. Drawing on sentiment analysis and related tools, social media is an effective way to increase brand awareness and customer engagement. Second, social media can become a very useful data collection tool when integrated with new AI-ML technologies. Using this function well requires researchers and practitioners to protect users' privacy carefully, such as through the deployment of privacy-enhancing technologies (PETs). Third, AI-ML enables organizations to maintain a long-term relationship with stakeholders. Chatbots and related tools can increase users' ability to receive personalized content. The review in this paper identifies research gaps in the literature. In view of these gaps, the paper proposes a conceptual framework that highlights essential components for better utilizing AI and ML. Additionally, it enables researchers and practitioners to better design social media platforms that minimize the spread of misinformation and address ethical concerns more readily. It also provides insights into the adoption of AI and ML in the context of remote patient monitoring and telehealth within social media platforms.

COVID-19 and Masking Disparities: Qualitative Analysis of Trust on the CDC's Facebook Page

This exploratory paper examines individual levels of risk assessment as impacting institutional trust in the CDC while also contributing to disparities in expressed willingness to mask early in the COVID-19 pandemic. Using both content and thematic analysis of the CDC's Facebook (FB) page from April 2020 and Gidden's modern risk society theory, I consider how social media (SM) users retrospectively perceived a dramatic change in public health (PH) advisory-from the CDC advising against masking in February 2020 (Time 1) to advising the use of "do-it-yourself" (DIY) cloth masking in April 2020 (Time 2)-through a lens of prior, self-guided research. Expressed "knowledge" of masking as preventative (or not) yielded unwavering and sometimes increasing distrust in the CDC based on user perception of the "correct" advisory, regardless of the CDC's position at Time 1 or Time 2. Simultaneously, disparities in masking behaviors appeared to be driven not by CDC guidance but by this same self-guided research. I show this via three themes: (1) claims of ineffectiveness for DIY masking (do not trust CDC now-no masking from the start); (2) conflict between the first and second CDC advisories on masking (do not trust CDC-either already masking anyway or will now); (3) disappointed in the CDC for length of time taken to make a DIY mask recommendation (do not trust CDC-either already masking anyway or will mask now). I discuss the imperative nature of two-way engagement with SM users by PH rather than using SM as a one-way mode of advisory dissemination. This and other recommendations may decrease disparities in preventative behaviors based on individual-level risk assessment as well as increase institutional trust and transparency.

"No more COVID-19 messages via social media, please": the mediating role of COVID-19 message fatigue between information overload, message avoidance, and behavioral intention

Employing the stressor-strain-outcome framework, this study demonstrates that COVID-19 information overload on social media exerts a significant effect on the level of fatigue toward COVID-19-related messages. This feeling of message fatigue also makes people avoid another exposure to similar types of messages while diminishing their intentions to adopt protective behaviors in response to the pandemic. Information overload regarding COVID-19 on social media also has indirect effects on message avoidance and protective behavioral intention against COVID-19, respectively, through the feeling of fatigue toward COVID-19 messages on social media. This study emphasizes the need to consider message fatigue as a significant barrier in delivering effective risk communication.

Advancing patient-centricity in Medical Affairs: a survey of patients and patient organizations

Current guidance on advancing patient-centricity in Medical Affairs is insufficient. A framework was previously proposed from a Medical Affairs perspective, without direct patient input, featuring five focus areas: medical strategy; medical communication; evidence generation; patient engagement; and patient care experience. We conducted a literature review to evaluate and provide background on those focus areas. Consequently, two new focus areas were identified: digital health and patient medical education. Because the patient perspective provides an important value-add, we consulted on the seven priority areas identified with patient and patient organizations through questionnaires. The gathered responses implied that they were accurately prioritized to increase patient-centricity. However, this must be tested on a larger sample size to validate its feasibility. Teaser: This article proposes an updated and actionable framework for Medical Affairs to advance patient-centricity efforts and is informed by the published literature and surveys of patients and patient organizations.

Use of Instagram to convey nutrition information to collegiate athletes

Background: Nutrition professionals, who work with collegiate athletes, use Instagram to provide nutrition information. Although, limited focus is on the engagement of these athletes. The purpose of this descriptive study was to investigate collegiate athletes' engagement, as indicated by the total number of likes received on posts, based on the nutrition content posted on Instagram. Methods: Over a five-week period, 15 randomly selected accounts were examined daily for posts made within specific research-defined categories (n = 12). The number of posts and subsequent post likes were summed and tabulated per category. Results: The food feature post category received the highest number of likes (n = 1,130) and posts (n = 33), whereas the macronutrient post category received the fewest number of likes (n = 43) and posts (n = 2). A two-sample t-test assuming unequal variances was conducted to compare account engagement as defined by the mean number of post likes within the same conferences. Two conferences had differences in the number of posts (p < 0.05). Discussion: Posting on a weekly basis and within specific categories appeared to produce a higher degree of engagement on collegiate sports nutrition Instagram accounts. Future research is needed to determine the percentage of athletes following these Instagram accounts and the impact these nutrition posts influences dietary behaviors.

Engagement with body image health promotion videos in adult men and women: differences between narrative, informational, and persuasive appeal approaches

BACKGROUND

Body dissatisfaction is a public health issue, however, low awareness of its seriousness, and stigma, may inhibit treatment seeking. The current study evaluated engagement with videos promoting awareness of body dissatisfaction using a persuasive communication approach.

METHOD

Men (n = 283) and women (n = 290) were randomly allocated to view one of five videos; (1) Narrative, (2) Narrative plus persuasive appeal, (3) Informational, (4) Informational plus persuasive appeal and (5) Persuasive appeal only. Engagement (relevance, interest, and compassion) was examined post-viewing.

RESULTS

Among both men and women, superior engagement ratings (in compassion for women, and relevance and compassion for men) were demonstrated for the persuasive appeal and informational videos relative to narrative approaches.

CONCLUSION

Videos using clear and factual approaches may promote engagement in body image health promotion videos. Further work should be done to examine interest in such videos specific to men.

How Misinformation and Rebuttals in Online Comments Affect People's Intention to Receive COVID-19 Vaccines: The Roles of Psychological Reactance and Misperceptions

This study investigated how exposure to negative and misleading online comments about the COVID-19 vaccination persuasive messages and the ensuing corrective rebuttals of these comments affected people's attitudes and intentions regarding vaccination. An online experiment was performed with 344 adults in the United States. The results showed that rebuttals by the Centers for Disease Control and Prevention, rather than those by social media users, indirectly increased people's willingness to receive the vaccine by reducing their psychological reactance to persuasive messages and their belief in the misinformation contained in the comments. Rebuttals by social media users became more effective in reducing reactance when people initially had stronger pro-vaccination attitudes.

Opioids in Satirical News Shows: Exploring Topics, Sentiments, and Engagement in Last Week Tonight on YouTube

Prescription drug misuse and opioid overdose have become one of the most serious health crises in the US health system. In this study, we examined Last Week Tonight as hosted by John Oliver in order to explore topics, sentiments, and reactions by referring to online comments on YouTube. Using an unsupervised machine learning approach, we analyzed 33,741 user generated comments taken from three selected episodes published between 2016 and 2021. Our results revealed 13 topics: the politicization of the opioid crisis, side effects of opioid use, seeking help, legal issues, reactions to the John Oliver show, drug addiction, the US in comparison with other countries, case settlements, the drug business, addiction and pharmaceutical companies, profitability of companies from deaths, drugs and elections, as well as general awareness and education. In addition, we found that opioid side effects, seeking help, and the drug business had received the highest user engagements in terms of likes and replies. Our study suggests that comments with positive sentiments were more likely to cause a more widespread engagement from YouTube users than negative comments.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

Self-Reported Student Awareness and Prevalence of Computer Vision Syndrome During COVID-19 Pandemic at Al-Baha University

BACKGROUND

The rapid increase increased, in using of video display terminals during the COVID-19 pandemic predisposes users to a variety of health problems restricted to visual problems and including various musculoskeletal problems, collectively known as computer vision syndrome (CVS) or computer vision syndrome.

AIM

This study aims to ascertain university students' awareness of computer vision syndrome at Al-Baha University, including the nature, sources, accuracy, and completeness of information, as well as the attitudes towards CVS, and mitigative practices.

METHODS

This study used a descriptive cross-sectional design and a convenient sample of 310 (80.0% male) students drawn from Al Baha University campuses. Data were collected using self-administered questionnaires.

RESULTS

The mean age of the participants was 23.51 years (SD=5.42). The results show that 78.7%, 66.1%, and 11.6% received CVS information from social media, mass media, and family, respectfully. Despite 70% of respondents being aware of CVS manifestations, between 42% to 67% of those sampled had accurate and complete information about the meaning, causes, prevention, and management of the syndrome. More than a third of the participants had either a good (62.9%) or average (29%) total knowledge of CVS. Less than 15% had incorrect information. On average, 62.5% of respondents engaged in preventive or mitigative behaviours/activities as opposed to 37.5% who did not, but only 44% believed CVS was a serious health threat. 65.2% of the studied students had a satisfactory total practice score. The regression analysis showed that the coefficients of marital status and faculty were a statistically significant association with the total knowledge score.

CONCLUSION

CVS awareness is acceptably high, but there is a low preventive/mitigative behaviors as well as a low realization of CVS' long-term health problems. This is why increasing CVS awareness and implementing interventions such as the 20-20-20 rule could be effective at Al Baha University.

How Public Health Agencies Break through COVID-19 Conversations: A Strategic Network Approach to Public Engagement

In times of public health emergencies, health agencies need to engage and communicate with the public in real-time to share updates and accurate information. This is especially the case for the COVID-19 pandemic where public engagement can potentially save lives and flatten the curve. This paper considers how the use of interactive features and strategic network positions of health agencies on social media influenced their public engagement outcomes. Specifically, we analyzed 203 U.S. public health agencies' Twitter activity and the public engagement they received by extracting data from a large-scale Twitter dataset collected from January 21st to May 31st, 2020. Results show that health agencies' network position in addition to their two-way communication strategy greatly influenced the level of public engagement with their COVID-19 related content on Twitter. Findings highlight the benefits of strategic social media communication of public health agencies resides not only in how agencies use social media but also in their formation of network position to amplify their visibility. As official sources of health and risk information, public health agencies should coordinate their social media communication efforts to strategically position themselves in advantageous network positions to augment public engagement outcomes.

Social Media Use in Hearing Loss, Tinnitus, and Vestibular Disorders: A Systematic Review

Background:

People are increasingly using social media outlets for gathering health-related information. There has also been considerable interest from researchers and clinicians in understanding how social media is used by the general public, patients, and health professionals to gather health-related information. Interest in the use of social media for audiovestibular disorders has also received attention, although published evidence synthesis of this use is lacking. The objective of this review article was to synthesize existing research studies related to social media use concerning hearing loss, tinnitus, and vestibular disorders.

Method:

Comprehensive searches were performed in multiple databases between October and November 2020 and again in June 2021 and March 2022, with additional reports identified from article citations and unpublished literature. This review article was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results:

A total of 1,512 articles were identified. Of these, 16 publications met the inclusion criteria. Overall, social media offered people the platform to learn about hearing loss, tinnitus, and vestibular disorders via advice and support seeking, personal experience sharing, general information sharing, and relationship building. Research studies were more common on information and user activities seen on Facebook Pages, Twitter, and YouTube videos. Misinformation was identified across all social media platforms for each of these conditions.

Conclusions:

Online discussions about audiovestibular disorders are evident, although inconsistencies in study procedures make it difficult to compare these discussion groups. Misinformation is a concern needing to be addressed during clinical consultations as well as via other public health means. Uniform guidelines are needed for research regarding the use of social media so that outcomes are comparable. Moreover, clinical studies examining how exposure to and engagement with social media information may impact outcomes (e.g., help seeking, rehabilitation uptake, rehabilitation use, and satisfaction) require exploration.

Supplemental Material:

https://doi.org/10.23641/asha.20667672

Monkeypox and Its Possible Sexual Transmission: Where Are We Now with Its Evidence?

Monkeypox is a rare disease but is increasing in incidence in different countries since the first case was diagnosed in the UK by the United Kingdom (UK) Health Security Agency on 6 May 2022. As of 9 August, almost 32,000 cases have been identified in 89 countries. In endemic areas, the monkeypox virus (MPXV) is commonly transmitted through zoonosis, while in non-endemic regions, it is spread through human-to-human transmission. Symptoms can include flu-like symptoms, rash, or sores on the hands, feet, genitalia, or anus. In addition, people who did not take the smallpox vaccine were more likely to be infected than others. The exact pathogenesis and mechanisms are still unclear; however, most identified cases are reported in men who have sex with other men (MSM). According to the CDC, transmission can happen with any sexual or non-sexual contact with the infected person. However, a recent pooled meta-analysis reported that sexual contact is involved in more than 91% of cases. Moreover, it is the first time that semen analysis for many patients has shown positive monkeypox virus DNA. Therefore, in this review, we will describe transmission methods for MPXV while focusing mainly on potential sexual transmission and associated sexually transmitted infections. We will also highlight the preventive measures that can limit the spread of the diseases in this regard.

#Laryngology: A Standardized Hashtag Ontology

BACKGROUND

In the past decade, there has been a rise in social media applications and usage among individuals in the otolaryngology- head and neck surgery (OHNS) community. Hashtags (#), used to identify posts relating to similar topics, are utilized to search medical information, build a network, find providers, and discuss research. Previous OHNS literature in this arena includes a standard ontology, or list of hashtags, developed for the otology subspecialty. To date, the ontology of laryngology hashtags has not been created. The objective of this study is to propose a standardized ontology to use when discussing topics in laryngology on social media to maximize reach and effect.

METHODS

Using a combination of previously published techniques, along with laryngology specific adjustments, the authors developed a list of suggested hashtags. An initial list was systematically culled from laryngology Instagram accounts including academic programs, laryngology influencers (fellowship-trained laryngologists with publicly available professional accounts with greater than 500 followers), and professional societies/conferences. The list was abbreviated using current rate of use, specificity, and expert opinion. These were then categorized to include general terms, diseases and diagnoses, and treatment strategies RESULTS: Across all culled Instagram posts, there were 240 unique laryngology hashtags used and 1152 total hashtags were applied. The authors derived unique terms to be included in the ontology for laryngology by expert opinion of fellowship-trained laryngologists.

CONCLUSION

Laryngology is in the early stages of utilization of social media. Developing a specific ontology of hashtags to be used will optimize the reach and connections of term specific searches.

COVID-19-Related Health Inequalities Induced by the Use of Social Media: Systematic Review

BACKGROUND

COVID-19-related health inequalities were reported in some studies, showing the failure in public health and communication. Studies investigating the contexts and causes of these inequalities pointed to the contribution of communication inequality or poor health literacy and information access to engagement with health care services. However, no study exclusively dealt with health inequalities induced by the use of social media during COVID-19.

OBJECTIVE

This review aimed to identify and summarize COVID-19-related health inequalities induced by the use of social media and the associated contributing factors and to characterize the relationship between the use of social media and health disparities during the COVID-19 pandemic.

METHODS

A systematic review was conducted on this topic in light of the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. Keyword searches were performed to collect papers relevant to this topic in multiple databases: PubMed (which includes MEDLINE [Ovid] and other subdatabases), ProQuest (which includes APA PsycINFO, Biological Science Collection, and others), ACM Digital Library, and Web of Science, without any year restriction. Of the 670 retrieved publications, 10 were initially selected based on the predefined selection criteria. These 10 articles were then subjected to quality analysis before being analyzed in the final synthesis and discussion.

RESULTS

Of the 10 articles, 1 was further removed for not meeting the quality assessment criteria. Finally, 9 articles were found to be eligible and selected for this review. We derived the characteristics of these studies in terms of publication years, journals, study locations, locations of study participants, study design, sample size, participant characteristics, and potential risk of bias, and the main results of these studies in terms of the types of social media, social media use-induced health inequalities, associated factors, and proposed resolutions. On the basis of the thematic synthesis of these extracted data, we derived 4 analytic themes, namely health information inaccessibility-induced health inequalities and proposed resolutions, misinformation-induced health inequalities and proposed resolutions, disproportionate attention to COVID-19 information and proposed resolutions, and higher odds of social media-induced psychological distress and proposed resolutions.

CONCLUSIONS

This paper was the first systematic review on this topic. Our findings highlighted the great value of studying the COVID-19-related health knowledge gap, the digital technology-induced unequal distribution of health information, and the resulting health inequalities, thereby providing empirical evidence for understanding the relationship between social media use and health inequalities in the context of COVID-19 and suggesting practical solutions to such disparities. Researchers, social media, health practitioners, and policy makers can draw on these findings to promote health equality while minimizing social media use-induced health inequalities.

Skin Cancer Narratives on Instagram: Content Analysis

Background

Skin cancer is among the deadliest forms of cancer in the United States. The American Cancer Society reported that 3 million skin cancer cases could be avoided every year if individuals are more aware of the risk factors related to sun exposure and prevention. Social media platforms may serve as potential intervention modalities that can be used to raise public awareness of several diseases and health conditions, including skin cancer. Social media platforms are efficient, cost-effective tools for health-related content that can reach a broad number of individuals who are already using these spaces in their day-to-day personal lives. Instagram was launched in 2010, and it is now used by 1 billion users, of which 90% are under the age of 35 years. Despite previous research highlighting the potential of image-based platforms in skin cancer prevention and leveraging Instagram’s popularity among the priority population to raise awareness, there is still a lack of studies describing skin cancer–related content on Instagram.

Objective

This study aims to describe skin cancer–related content on Instagram, including the type of account; the characteristics of the content, such as the kind of media used; and the type of skin cancer discussed. This study also seeks to reveal content themes in terms of skin cancer risks, treatment, and prevention.

Methods

Through CrowdTangle, a Facebook-owned tool, we retrieved content from publicly available accounts on Instagram for the 30 days preceding May 14, 2021. Out of 2932 posts, we randomly selected 1000 posts for review. Of the 1000 posts, 592 (59.2%) met the following inclusion criteria: (1) content was focused on human skin cancer, (2) written in English language only, and (3) originated from the United States. Guided by previous research and through an iterative process, 2 undergraduate students independently coded the remaining posts. The 2 coders and a moderator met several times to refine the codebook.

Results

Of the 592 posts, profiles representing organizations (n=321, 54.2%) were slightly more common than individual accounts (n=256, 43.2%). The type of media included in the posts varied, with posts containing photos occurring more frequently (n=315, 53.2%) than posts containing infographics (n=233, 39.4%) or videos (n=85, 14.4%). Melanoma was the most mentioned type of skin cancer (n=252, 42.6%). Prevention methods (n=404, 68.2%) were discussed in Instagram posts more often than risk factors (n=271, 45.8%). Only 81 out of 592 (13.7%) posts provided a citation.

Conclusions

This study’s findings highlight the potential role of Instagram as a platform for improving awareness of skin cancer risks and the benefits of prevention practices. We believe that social media is the most promising venue for researchers and dermatologists to dedicate their efforts and presence that can widely reach the public to educate about skin cancer and empower prevention.

Facebook Feeds and Child Feeding: A Qualitative Study of Thai Mothers in Online Child Feeding Support Groups

Mothers have traditionally sought child feeding information from social connections. While mothers are heavily engaged on social media and value peer support in online communities, very little is known about how they use online communities for information about child feeding practices after exclusive breastfeeding cessation. This study explores mothers' perceptions of joining Facebook child feeding support groups. Individual semi-structured interviews with ten Thai mothers were conducted. The transcribed interviews were analyzed using a phenomenological hermeneutical approach. Our findings highlighted that Thai mothers participated in Facebook child feeding support groups in a deliberate effort to reduce their uncertainty by normalizing the process through accessing the shared experiences of others. One of their intentions was to seek menu recipes based on favorable psychosocial and environmental factors. Implications for using social media in health promotion and communication include the importance of building appropriate common practices through social collaboration and interactivity to supplement traditional knowledge and attitudes.

Comparison of public discussions of gene editing on social media between the United States and China

The world’s first gene-edited babies event has stirred controversy on social media over the use of gene editing technology. Understanding public discussions about this controversy will provide important insights about opinions of science and facilitate informed policy decisions. This study compares public discussion topics about gene editing on Twitter and Weibo, as wel asthe evolution of these topics over four months. Latent Dirichlet allocation (LDA) was used to generate topics for 11,244 Weibo posts and 57,525 tweets from September 25, 2018, to January 25, 2019. Results showed a difference between the topics on Twitter versus Weibo: there were more nuanced discussions on Twitter, and the discussed topics between platforms focused on different areas. Temporal analysis showed that most discussions took place around gene-edited events. Based on our findings, suggestions were provided for policymakers and science communication practitioners to develop more effective communication strategies toward audiences in China and the U.S.

A content analysis of Canadian influencer crisis messages on Instagram and the public’s response during COVID-19

Successful mitigation of emerging infectious disease requires that the public adopt recommended behaviours, which is directly influenced by effective crisis communication. Social media has become an important communication channel during COVID-19 where official actors, influencers, and the public are co-creating crisis messages. Our research examined COVID-19-related crisis messages across Canadian influencer accounts within news media, politicians, public health and government, science communicators, and brand influencer and celebrities, posted on Instagram between December 2019 and March 2021 for Health Belief Model and Extended Parallel Processing Model constructs and the corresponding public comment sentiment and engagement. Thirty-three influencer accounts resulted in a total of 2,642 Instagram posts collected, along with 461,436 comments, which showed overall low use of constructs in both captions and images. Further, most posts used no combinations (n = 0 or 1 construct per post) of constructs in captions and images and very infrequently used captions that combined threat (severity and susceptibility) with cues to action and efficacy. Brand influencers and celebrities, politicians, and science communicators had above average post engagement while public health and government and news media had lower. Finally, most influencers saw the largest proportion of neutral sentiment comments. Crisis messages must be designed to include combinations of constructs that increase message acceptance and influence risk perception and efficacy to increase the adoption of recommended and mandated behaviours.

Observational Study of the Impact of a Food Safety Intervention on Consumer Poultry Washing

ABSTRACT

This study was conducted to test the effectiveness of a consumer poultry washing educational intervention that included video observation of meal preparation with participants who self-reported washing poultry. Treatment group participants received three e-mail messages containing information that the U.S. Department of Agriculture has used on social media sites (video and infographics) related to poultry preparation, including advising against washing chicken. Participants were observed cooking chicken thighs (inoculated with traceable nonpathogenic Escherichia coli strain DH5α) and preparing a salad to determine whether they washed the chicken and the extent of cross-contamination to the salad and areas of the kitchen. After meal preparation, participants responded to an interview about food handling behaviors, including questions about the intervention for treatment group participants. Three hundred people participated in the study (158 control, 142 treatment). The intervention effectively encouraged participants not to wash chicken before cooking; 93% of treatment group participants but only 39% of control group participants did not wash the chicken (P < 0.0001). The high levels of E. coli DH5α detected in the sink and on the salad lettuce suggest that microbes transferred to the sink from the chicken, packaging, or contaminated hands are a larger cause for concern than is splashing contaminated chicken fluids onto the counter. Among chicken washers, 26 and 30% of the lettuce from the prepared salad was contaminated for the control and treatment groups, respectively. For nonwashers, 31 and 15% of the lettuce was contaminated for the control and treatment groups, respectively. Hand-facilitated cross-contamination is suspected to be a factor in explaining this resulting lettuce cross-contamination. This study demonstrates the need to change the frame of "don't wash your poultry" messaging to instead focus on preventing contamination of sinks and continuing to emphasize the importance of hand washing and cleaning and sanitizing surfaces.

HIGHLIGHTS

Contextualizing Engagement With Health Information on Facebook: Using the Social Media Content and Context Elicitation Method

Background

Most of what is known regarding health information engagement on social media stems from quantitative methodologies. Public health literature often quantifies engagement by measuring likes, comments, and/or shares of posts within health organizations’ Facebook pages. However, this content may not represent the health information (and misinformation) generally available to and consumed by platform users. Furthermore, some individuals may prefer to engage with information without leaving quantifiable digital traces. Mixed methods approaches may provide a way of surpassing the constraints of assessing engagement with health information by using only currently available social media metrics.

Objective

This study aims to discuss the limitations of current approaches in assessing health information engagement on Facebook and presents the social media content and context elicitation method, a qualitatively driven, mixed methods approach to understanding engagement with health information and how engagement may lead to subsequent actions.

Methods

Data collection, management, and analysis using the social media content and context elicitation method are presented. This method was developed for a broader study exploring how and why US Latinos and Latinas engage with cancer prevention and screening information on Facebook. The study included 20 participants aged between 40 and 75 years without cancer who participated in semistructured, in-depth interviews to discuss their Facebook use and engagement with cancer information on the platform. Participants accessed their Facebook account alongside the researcher, typed cancer in the search bar, and discussed cancer-related posts they engaged with during the previous 12 months. Engagement was defined as liking, commenting, and/or sharing a post; clicking on a post link; reading an article in a post; and/or watching a video within a post. Content engagement prompted questions regarding the reasons for engagement and whether engagement triggered further action. Data were managed using MAXQDA (VERBI GmbH) and analyzed using thematic and content analyses.

Results

Data emerging from the social media content and context elicitation method demonstrated that participants mainly engaged with cancer prevention and screening information by viewing and/or reading content (48/66, 73%) without liking, commenting, or sharing it. This method provided rich content regarding how US Latinos and Latinas engage with and act upon cancer prevention and screening information on Facebook. We present 2 emblematic cases from the main study to exemplify the additional information and context elicited from this methodology, which is currently lacking from quantitative approaches.

Conclusions

The social media content and context elicitation method allows a better representation and deeper contextualization of how people engage with and act upon health information and misinformation encountered on social media. This method may be applied to future studies regarding how to best communicate health information on social media, including how these affect assessments of message credibility and accuracy, which can influence health outcomes.

The reach, influence and tenor of professional orthodontic societies on social media: A cross-sectional content analysis

BACKGROUND AND OBJECTIVES

Orthodontic societies should support the profession and improve patient awareness. We aimed to investigate the scope and influence of orthodontic societies on social media.

METHOD

A total of 120 orthodontic societies were identified on the World Federation of Orthodontists (WFO) affiliates list. Presence of orthodontic societies on Instagram, Facebook and Twitter was ascertained. All societies with Instagram accounts were included for further analysis of the nature and content of posts as well as user engagement. Pilot coding and thematic analysis were undertaken (n=200 posts). The most recent 20% of the total number of posts for each account were then analysed for content.

RESULTS

Only 10 (8.3%), 34 (28.3%) and 52 (43.3%) orthodontic societies had accounts on Twitter, Instagram and Facebook, respectively. A total of 2124 Instagram posts were analysed. On average, 318 posts were identified per account (range=1 to 1901). The average number of followers was 2337 (range=85 to 11,400) with average user engagement of 1.25% (range=0.0%-7.17%). A total of 6 themes (subthemes; n=28) were identified including "announcements on professional events" (51.6%), "patient education, enlightenment and commendation" (26%), "running and operation of the society" (9.1%), "highlighting research and evidence" (3.1%), "COVID-related advice and updates" (4%) and "observance and commemoration" (10.4%). The posts targeting patients were limited (18.7%).

CONCLUSIONS

The limited reach of the accounts of international orthodontic societies highlights the need to develop a more effective and influential social media presence. Orthodontic societies should involve members, providers and patients in developing more effective social media resources.

Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review

Background

“Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them.

Methods

We adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health.

Results and analysis

Overall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement.

Conclusion

Developing and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.

WhatsApp and Health Communication

Little is known about the use of WhatsApp in promoting oral health among parents or caregivers. Therefore, the survey examined the impact of social media in disseminating health infographic messages in supporting children's oral health from the parent's perspective. The group of respondents read or saw posts or messages related to health education through Facebook (n=85, 31.9%), WhatsApp (n=68, 25.2%), and YouTube (n=61, 22.6%). There was a significant difference before and after the infographics were sent to the respondent, and it was found to be statistically significant (P-value &lt;0.001). As a social media platform for oral health education purposes, WhatsApp appeared to improve parents' knowledge and behaviors towards their children's oral health. Most respondents perceived WhatsApp to be beneficial. Knowing how people use social media now could help health communication efforts be more effective and equitable.

Can Social Media Be Used as a Community-Building and Support Tool among Jewish Women Impacted by Breast and Ovarian Cancer? An Evidence-Based Observational Report

About 1 in 40 Ashkenazi Jewish women carry a deleterious mutation in BRCA1/2 genes, predisposing them to hereditary breast/ovarian cancer (HBOC). Thus, efforts to prevent and control HBOC in the US must include sufficient outreach and education campaigns within and across the Jewish community. Social media (SM) is utilized in public health campaigns focused on cancer, but very little is known about the efficacy of those efforts when directed toward Jewish women at risk for (“previvors”) and affected by (“survivors”) HBOC. Here, we report on outcomes of a targeted SM campaign for this population, as led by a national not-for-profit HBOC advocacy organization. Mixed-methods data were obtained from n = 393 members of the community, including n = 20 key informants, and analyzed for engagement and satisfaction with its SM campaign and HBOC resources. Message recipients identified the SM campaign as helpful/meaningful (82%), of ‘newsworthy’ value (78%), and actionable/navigable (71%): interviews revealed that women were more likely to engage with SM if/when it featured stories relevant to their personal cancer experiences. SM is a valuable public health education tool to address the comprehensive cancer control and prevention needs of those previving and surviving with HBOC, including high-risk Jewish women.

Estimating the Cost of the Design, Production, and Dissemination of Social Media Videos for Social and Behavioral Change: Evidence From Merci Mon Héros in Niger and Côte d'Ivoire

Merci Mon Héros (MMH) is a youth-led multi-media campaign in Francophone West Africa seeking to improve reproductive health and family planning outcomes using radio, television, social media, and community events. One component to this project is the development of a series of youth-driven videos created to encourage both youth and adults to break taboos by talking to each other about reproductive health and family planning. A costing study was conducted to capture costs associated with the design, production, and dissemination of 11 MMH videos (in French) on social media in Côte d'Ivoire and Niger. The total costs to design, produce and disseminate 11 of the campaign videos for MMH in both Côte d'Ivoire and Niger were $44,981. Unit costs were calculated using three different denominators, resulting in average unit costs of $0.16 per reach, $1.29 per engagement, and $4.27 per video view. These findings can be useful for future studies of SBC interventions using social media for framing the analysis and selecting the appropriate metrics for the denominator, as well as for budgeting and planning SBC programs using social media.

The role of social influencers for effective public health communication

Purpose

The purpose of the study is to explore the suitability of social media influencers (SMIs) for communicating public health messages via social media platforms. The study identifies key persuasive communication components that influence individuals' attitudes and, subsequently, intentions to follow health-related information shared by SMIs.

Design/methodology/approach

Qualitative interviews with healthcare workers and interactions with 332 active social media users via structured online questionnaires were used for data collection. Structural equation modelling was used to analyse responses.

Findings

Results indicate that SMIs' credibility, SMI–individual homophily and quality of information shared by the SMI are the significant factors determining individuals' attitudes towards the information received. Furthermore, the individual's attitude significantly impacts their intention to follow information shared by the SMI. The study thus verifies the mediating role of attitude in persuasive communication.

Research limitations/implications

The current study can serve as a foundation for future work to examine the suitability of SMIs for tasks other than marketing.

Practical implications

The study provides insights for planning and implementing SMI-sourced communication in the public health context. The study enhances the understanding of the tested relationships and thereby increases scholars' and practitioners' ability to leverage SMIs for health-related communication.

Originality/value

Whilst SMIs are attracting increasing attention in consumer markets, the study suggests that they can be used in public health communication. Considering the coronavirus disease (COVID-19) situation, the empirical study provides insights into SMIs' role in persuasive public health communication amid a health crisis.

Peer review

The peer review history for the article is available at: https://publons.com/publon/10.1108/OIR-01-2021-0012

The Role of Social Media in Raising Public Health Awareness during the Pandemic COVID-19: An International Comparative Study

The main objective of this research is to investigate the role of social media campaigns (the type of social media platform, type of message, and message source sender) in raising public health awareness and behavioral change during (COVID-19) as a global pandemic across national selected countries (Poland and Jordan). The research utilizes a quantitative method with an exploratory and descriptive design to accumulate the initial data from a research survey given to the respondents from Jordan and Poland. A total of 1149 web questionnaires were collected from respondents in the two countries (Poland 531 and Jordan 618). In addition, multiple regression analysis was used to test the study hypotheses. The findings showed positive relationships between the components of a social media campaign, public health awareness, and behavioral change during (COVID-19) in the two countries at the same time. However, the preferred type of social media platforms, the message types and type of source sender significantly differ among the respondents due to their countries. This is the first study that examines the role of social media campaigns (the type of social media platform, type of message and message source sender) in public health awareness and behavioral change during (COVID-19) as a global pandemic in across national selected countries (Poland and Jordan).

Why DO citizens engage in government social media accounts during COVID-19 pandemic? A comparative study

The worldwide COVID-19 outbreak that crushed the global economy and healthcare increased the public willingness to acquire more information and enthusiasm to engage online among billions of users through social networks. As more towns, cities, and regions turn to lockdown, government social media accounts (GSMAs) develop as a trustworthy source to obtain information about the COVID-19 pandemic. Thus, investigating the determinants and consequences of citizens' participation behavior on GSMAs is essential. Drawing on the self-determination theory (SDT) and civic volunteer model (CVM), we examine the influence of motivational factors (i.e., intrinsic extrinsic) on citizens' participation behavior on GSMAs, which leads to online civic behavior. Comparative research between China and Pakistan is carried out using data collected through an online survey. This study shows that information-seeking, political benefits, self-development, altruism, and perceived reciprocity are the critical antecedents of citizens' participatory behavior on GSMAs in both countries, resulting in online civic behavior. Furthermore, moderating results reveal that perceived connectivity moderates the relationship between certain motivational factors (intrinsic and extrinsic) and citizens' participatory behavior on GSMAs, whereas trust in government moderates the relationship between participatory behavior on GSMAs and online civic behavior during COVID-19. Theoretical and managerial implications are discussed in detail.

User and Message Level Correlates of Endorsement and Engagement for HIV-related Messages on Twitter: cross sectional study (Preprint)

Background

Youth and young adults continue to experience high rates of HIV and are also frequent users of social media. Social media platforms such as Twitter can bolster efforts to promote HIV prevention for these individuals, and while HIV-related messages exist on Twitter, little is known about the impact or reach of these messages for this population.

Objective

This study aims to address this gap in the literature by identifying user and message characteristics that are associated with tweet endorsement (favorited) and engagement (retweeted) among youth and young men (aged 13-24 years).

Methods

In a secondary analysis of data from a study of HIV-related messages posted by young men on Twitter, we used model selection techniques to examine user and tweet-level factors associated with tweet endorsement and engagement.

Results

Tweets from personal user accounts garnered greater endorsement and engagement than tweets from institutional users (aOR 3.27, 95% CI 2.75-3.89; P<.001). High follower count was associated with increased endorsement and engagement (aOR 1.05, 95% CI 1.04-1.06; P<.001); tweets that discussed STIs garnered lower endorsement and engagement (aOR 0.59, 95% CI 0.47-1.74; P<.001).

Conclusions

Findings suggest practitioners should partner with youth to design and disseminate HIV prevention messages on social media, incorporate content that resonates with youth audiences, and work to challenge stigma and foster social norms conducive to open conversation about sex, sexuality, and health.

Influencing Factors on Health Information to Improve Public Health Literacy in the Official WeChat Account of Guangzhou CDC

Background: Social media is used as a new channel for health information. In China, the official WeChat account is becoming the most popular platform for health information dissemination, which has created a good opportunity for the Centers for Disease Control and Prevention to facilitate health information online to improve emergency public health literacy. Methods: Data were collected from the Guangzhou CDC i-Health official WeChat account between April 1, 2018 and April 30, 2019. Descriptive analysis was performed for basic information about the followers and posts of the official WeChat account. Multiple logistic regression analysis was used to analyze the association among various factors of posts on engagement of followers of the official WeChat account. Results: Among 187,033 followers, the total numbers of post views, shares, likes, add to favorites, and comments for 213 posts were 1,147,308, 8,4671, and 5,535, respectively. Engagement of followers peaked on the dissemination date and gradually declined. The main post topics were health education posts and original posts. In the multiple logistic regression model, the number of post views was found to be significantly associated with infectious disease posts (AOR: 3.20, 95% CI: 1.16-8.81), original posts (AOR: 10.20, 95% CI: 1.17-89.28), and posts with title-reflected content (AOR: 2.93, 95% CI: 1.16-8.81). Conclusion: Our findings facilitate the government to formulate better strategies and improve the effectiveness of public information dissemination.

Communicating COVID-19 information on TikTok: a content analysis of TikTok videos from official accounts featured in the COVID-19 information hub

Amid the COVID-19 pandemic, TikTok, an emerging social media platform, has created an information hub to provide users with engaging and authoritative COVID-19 information. This study investigates the video format, type and content of the COVID-19 TikTok videos, and how those video attributes are related to quantitative indicators of user engagement, including numbers of views, likes, comments and shares. A content analysis examined 331 videos from official accounts featured in the COVID-19 information hub. As of 5 May 2020, the videos received 907 930 000 views, 29 640 000 likes, 168 880 comments and 781 862 shares. About one in three videos had subtitles, which were positively related to the number of shares. Almost every video included a hashtag, and a higher number of hashtags was related to more likes. Video types included acting, animated infographic, documentary, news, oral speech, pictorial slideshow and TikTok dance. Dance videos had the most shares. Video themes included anti-stigma/anti-rumor, disease knowledge, encouragement, personal precautions, recognition, societal crisis management and work report. Videos conveying alarm/concern emotions, COVID-19 susceptibility and severity, precaution response efficacy had higher user engagement. Public health agencies should be aware of the opportunity of TikTok in health communication and create audience-centered risk communication to engage and inform community members.

Exploring the Social Networks' Use in the Health-Care Industry: A Multi-Level Analysis

The application of social networks in the health domain has become increasingly prevalent. They are web-based technologies which bring together a group of people and health-care providers having in common health-related interests, who share text, image, video and audio contents and interact with each other. This explains the increasing amount of attention paid to this topic by researchers who have investigated a variety of issues dealing with the specific applications in the health-care industry. The aim of this study is to systematize this fragmented body of literature, and provide a comprehensive and multi-level overview of the studies that has been carried out to date on social network uses in healthcare, taking into account the great level of diversity that characterizes this industry. To this end, we conduct a scoping review enabling to identify the major research streams, whose aggregate knowledge are discussed according to three levels of analysis that reflect the viewpoints of the major actors using social networks for health-care purposes, i.e., governments, health-care providers (including health-care organizations and professionals) and social networks’ users (including ill patients and general public). We conclude by proposing directions for future research.

Social Media and Video Conferencing Platforms for Group Therapy and Community Mental Health Outreach for LGBTQIA+ Individuals— The SAAHAS Experience

E-health and telehealth are rapidly evolving areas of intervention that may show high potential for use with LGBTQIA+ individuals. Research on the therapeutic utility of these with respect to mental health is limited, particularly in India. SAAHAS (Sexuality, Acceptance, Awareness, Health, and Support) is a queer-affirmative, cognitive behavior therapy-based group therapy model of intervention for LGBTQIA+ individuals. We describe here our facilitator experience with expanding the offline group therapy model to online platforms using Google Meet, with an analysis of attendance and modalities of engagement and a description of our therapy notes and themes of discussion. We describe facilitator experience of continued therapeutic support through WhatsApp by analyzing the chats and thematic coding of the same. We also describe here our attempt at using social media for community mental health outreach through dissemination of mental health messages on Instagram and Facebook; data was analyzed using engagement metrics. Observations of the utility and limitations of these video conferencing and social media platforms and suggestions for effective use are provided.