Source does matter: Contextual effects on online media-embedded health campaigns against childhood obesity

Nutrition and Food Literacy: Framing the Challenges to Health Communication

Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations. In addition, food literacy is a complex and multidisciplinary field, and there are numerous challenges to health communication that must be addressed to effectively promote food literacy and improve health outcomes. Addressing food illiteracy and the challenges to health communication is essential to promote health equity and improve health outcomes for all populations.

Need for Cognition Among Users of Self-Monitoring Systems for Physical Activity: Survey Study

Background

Need for cognition (NFC) is among the most studied personality traits in psychology. Despite its apparent relevance for engaging with technology and the use of information, it has not been studied in the context of self-monitoring systems and wearables for health. This study is the first to explore the relationship between NFC and commercial self-monitoring systems among healthy users.

Objective

This study aims to explore the effect of NFC levels on the selection of self-monitoring systems and evaluation of system features of self-monitoring and feedback, as well as perceived credibility and perceived persuasiveness. We also assessed perceived behavior change in the form of self-reported activity after adopting the system.

Methods

Survey data were collected in October 2019 among university students and personnel. The invitation to respond to the questionnaire was addressed to those who had used a digital system to monitor their physical activity for at least two months. The web-based questionnaire comprised the following 3 parts: details of system use, partially randomly ordered theoretical measurement items, and user demographics. The data were analyzed using structural equation modeling. The effect of NFC was assessed both as 3 groups (low, moderate, and high) and as a continuous moderator variable.

Results

In all, 238 valid responses to the questionnaire were obtained. Individuals with high NFC reported all tested system features with statistically significantly higher scores. The NFC also had some effect on system selection. Hypothesized relationships with perceived credibility gained support in a different way for individuals with low and high NFC; for those with low NFC, credibility increased the persuasiveness of the system, but this effect was absent among individuals with high NFC. For users with high NFC, credibility was related to feedback and self-monitoring and perhaps continuously evaluated during prolonged use instead of being a static system property. Furthermore, the relationship between perceived persuasiveness and self-reported activity after adopting the system had a large effect size (Cohen f²=0.355) for individuals with high NFC, a small effect size for individuals with moderate NFC (Cohen f²=0.107), and a nonsignificant path (P=.16) for those with low NFC. We also detected a moderating effect of NFC in two paths on perceived persuasiveness but only among women. Our research model explained 59.2%, 63.9%, and 47.3% of the variance in perceived persuasiveness of the system among individuals with low, moderate, and high NFC, respectively.

Conclusions

The system choices of individuals seem to reflect their intrinsic motivations to engage with rich data, and commercial systems might themselves be a tailoring strategy. Important characteristics of the system, such as perceived credibility, have different roles depending on the NFC levels. Our data demonstrate that NFC as a trait that differentiates information processing has several implications for the selection, design, and tailoring of self-monitoring systems.

Patients With Super Obesity Do Not Perceive Themselves as Being at Higher Risk for a More Severe Course of COVID-19 Infection

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has led to major health-related concerns in the population. Several risk factors for a severe course of COVID-19 disease have been identified, with obesity taking an important role. However, it is unclear whether this association is only known in the expert world or whether individuals also experience themselves as risk patients due to their obesity and whether the desire for weight reduction may also be associated with a hoped-for risk reduction. These questions were addressed in a cross-sectional study of patients who have presented to an obesity center in order to lose body weight.

METHODS

Patients (n = 155) of the obesity center were asked to complete an ad hoc questionnaire to assess whether the desire to lose weight is also associated with a hoped-for risk reduction with respect to COVID-19 disease during the middle of the pandemic in the period between October 2020 and April 2021. We additionally assessed their perceived general stress using the Perceived Stress Questionnaire (PSQ).

RESULTS

In our explorative study, overall worries correlated significantly with worries about contracting COVID-19 (r = 0.483, p < 0.001). There has been an association with concerns about severe COVID-19 progression and psychological distress from the COVID-19 pandemic (r = 0.543, p < 0.001). In addition, a correlation was found between persons who worry about contracting COVID-19 and feeling like an at-risk patient (r = 0.530, p < 0.001). Interestingly, the higher the BMI (>50 kg/m²), the lower were the worries in PSQ (ANOVA p = 0.046). However, COVID-19-related worry was nonetheless present in the higher BMI subgroups. The most intense worries were experienced by individuals with a BMI between 35 and 39 (PSQ worries 50.44), immediately followed by individuals with a BMI between 40 and 49 (PSQ worries 49.36).

DISCUSSION AND CONCLUSION

An increased risk for a more severe course of COVID-19 infection is not generally perceived by obese individuals. In particular, individuals with very high BMI (>50)-although being at very high risk for a severe course of the COVID-19 disease-do not display increased worries, which might point toward heightened denial.

Using Social Media to Understand Online Social Factors Concerning Obesity: A Systematic Review (Preprint)

Background

Evidence in the literature surrounding obesity suggests that social factors play a substantial role in the spread of obesity. Although social ties with a friend who is obese increase the probability of becoming obese, the role of social media in this dynamic remains underexplored in obesity research. Given the rapid proliferation of social media in recent years, individuals socialize through social media and share their health-related daily routines, including dieting and exercising. Thus, it is timely and imperative to review previous studies focused on social factors in social media and obesity.

Objective

This study aims to examine web-based social factors in relation to obesity research.

Methods

We conducted a systematic review. We searched PubMed, Association for Computing Machinery, and ScienceDirect for articles published by July 5, 2019. Web-based social factors that are related to obesity behaviors were studied and analyzed.

Results

In total, 1608 studies were identified from the selected databases. Of these 1608 studies, 50 (3.11%) studies met the eligibility criteria. In total, 10 types of web-based social factors were identified, and a socioecological model was adopted to explain their potential impact on an individual from varying levels of web-based social structure to social media users’ connection to the real world.

Conclusions

We found 4 levels of interaction in social media. Gender was the only factor found at the individual level, and it affects user’s web-based obesity-related behaviors. Social support was the predominant factor identified, which benefits users in their weight loss journey at the interpersonal level. Some factors, such as stigma were also found to be associated with a healthy web-based social environment. Understanding the effectiveness of these factors is essential to help users create and maintain a healthy lifestyle.

Perceptions of Food Hypersensitivity Expertise on Social Media: Qualitative Study

Background

Seeking and sharing information are the primary uses of the internet and social media. It is therefore vital to understand the processes individuals go through when engaging with information on these diverse platforms, especially in areas such as health- and risk-related information. One important element of such engagement is evaluating and attributing expertise to others.

Objective

This study aimed to explore how meanings around expertise in relation to food allergy and intolerance (food hypersensitivity) were constructed by 2 groups of social media users: (1) those who use platforms for reasons relating to food hypersensitivity and (2) those seen as experts by this community.

Methods

Survey participants were asked open-ended questions to identify potential experts in food hypersensitivity issues on social media and to discuss their reasoning for their choices (n=143). Subsequently, 8 adult social media users with experience of managing food hypersensitivity and 5 participants designated as experts by those users took part in email interviews. Survey and interview data were analyzed thematically using Braun and Clarke’s approach.

Results

Judging expertise on social media is a complex and multifaceted process. Users might be judged as experts through their professional background or their experience living with food hypersensitivities. How users behave on social media and the traces of their Web-based activity can influence how others will see them. Such considerations are both measured and moderated through the social media community itself. Findings highlighted how social media often act as a supportive information tool following a diagnosis, but this also raised concerns regarding the scenario of patients not being able to access suitable vetted information.

Conclusions

This work has implications for understanding how users perceive expertise on social media in relation to a health concern and how information assessments are made during the management of risks. Findings provide practical insights to both medical and organizational stakeholders involved in the support of those living with life-changing conditions, such as food hypersensitivities.

Tweeting and Eating: The Effect of Links and Likes on Food-Hypersensitive Consumers' Perceptions of Tweets

Moving on from literature that focuses on how consumers use social media and the benefits of organizations utilizing platforms for health and risk communication, this study explores how specific characteristics of tweets affect the way in which they are perceived. An online survey with 251 participants with self-reported food hypersensitivity (FH) took part in an online experiment to consider the impact of tweet characteristics on perceptions of source credibility, message credibility, persuasiveness, and intention to act upon the presented information. Positioning the research hypotheses within the framework of the Elaboration Likelihood Model and Uses and Gratifications Theory, the study explored motivations for using social media and tested the impact of the affordances of Twitter—(1) the inclusion of links and (2) the number of social validation indicators (likes and retweets). Having links accompanying tweets significantly increased ratings of the tweets’ message credibility, as well as persuasiveness of their content. Socially validated tweets had no effect on these same variables. Parents of FH children were found to utilize social media for social reasons more than hypersensitive adults; concern level surrounding a reaction did not appear to alter the level of use. Links were considered valuable in obtaining social media users to attend to useful or essential food health and risk information. Future research in this area can usefully consider the nature and the effects of social validation in relation to other social media platforms and with other groups.

Youth Mental Health Services Utilization Rates After a Large-Scale Social Media Campaign: Population-Based Interrupted Time-Series Analysis

BACKGROUND

Despite the uptake of mass media campaigns, their overall impact remains unclear. Since 2011, a Canadian telecommunications company has operated an annual, large-scale mental health advocacy campaign (Bell Let's Talk) focused on mental health awareness and stigma reduction. In February 2012, the campaign began to explicitly leverage the social media platform Twitter and incented participation from the public by promising donations of Can $0.05 for each interaction with a campaign-specific username (@Bell_LetsTalk).

OBJECTIVE

The intent of the study was to examine the impact of this 2012 campaign on youth outpatient mental health services in the province of Ontario, Canada.

METHODS

Monthly outpatient mental health visits (primary health care and psychiatric services) were obtained for the Ontario youth aged 10 to 24 years (approximately 5.66 million visits) from January 1, 2006 to December 31, 2015. Interrupted time series, autoregressive integrated moving average modeling was implemented to evaluate the impact of the campaign on rates of monthly outpatient mental health visits. A lagged intervention date of April 1, 2012 was selected to account for the delay required for a patient to schedule and attend a mental health-related physician visit.

RESULTS

The inclusion of Twitter into the 2012 Bell Let's Talk campaign was temporally associated with an increase in outpatient mental health utilization for both males and females. Within primary health care environments, female adolescents aged 10 to 17 years experienced a monthly increase in the mental health visit rate from 10.2/1000 in April 2006 to 14.1/1000 in April 2015 (slope change of 0.094 following campaign, P<.001), whereas males of the same age cohort experienced a monthly increase from 9.7/1000 to 9.8/1000 (slope change of 0.052 following campaign, P<.001). Outpatient psychiatric services visit rates also increased for both male and female adolescents aged 10 to 17 years post campaign (slope change of 0.005, P=.02; slope change of 0.003, P=.005, respectively). For young adults aged 18 to 24 years, females who used primary health care experienced the most significant increases in mental health visit rates from 26.5/1000 in April 2006 to 29.2/1000 in April 2015 (slope change of 0.17 following campaign, P<.001).

CONCLUSIONS

The 2012 Bell Let's Talk campaign was temporally associated with an increase in the rate of mental health visits among Ontarian youth. Furthermore, there appears to be an upward trend of youth mental health utilization in the province of Ontario, especially noticeable in females who accessed primary health care services.