The impact of a social media literacy intervention on positive attitudes to tanning: A pilot study

Cancer fatalism, social media informational awareness, and education

OBJECTIVE

Understand if cancer fatalism among adult social media users in the United States is linked to social media informational awareness and if the relationship varies by education level.

METHODS

Cross-sectional data from the 2022 Health Information National Trends Survey (n = 3,948) were analyzed using multivariable linear probability models. The study population was defined as social media users active within the past year. The outcome variable was cancer fatalism and the predictor variables were social media informational awareness and education level.

RESULTS

Participants with low social media informational awareness were 9% (95% CI = 3, 15), 6% (95% CI = 1, 11), and 21% (95% CI = 14, 27) percentage points more likely to agree that it seems like everything causes cancer, you cannot lower your chances of getting cancer, and there are too many cancer prevention recommendations to follow, respectively. Participants with a college degree or higher level of education and who reported high social media informational awareness were the least likely to agree that everything causes cancer (60%; 95% CI = 54, 66), you cannot lower your chances of getting cancer (14%; 95% CI = 10, 19), and there are too many cancer prevention recommendations to follow (52%; 95% CI = 46, 59).

CONCLUSION

Social media informational awareness was associated with lower levels of cancer fatalism among adult social media users. College graduates with high social media informational awareness were the least likely to report cancer fatalism.

The New Media Landscape and Its Effects on Skin Cancer Diagnostics, Prognostics, and Prevention: Scoping Review

BACKGROUND

The wide availability of web-based sources, including social media (SM), has supported rapid, widespread dissemination of health information. This dissemination can be an asset during public health emergencies; however, it can also present challenges when the information is inaccurate or ill-informed. Of interest, many SM sources discuss cancer, specifically cutaneous melanoma and keratinocyte cancers (basal cell and squamous cell carcinoma).

OBJECTIVE

Through a comprehensive and scoping review of the literature, this study aims to gain an actionable perspective of the state of SM information regarding skin cancer diagnostics, prognostics, and prevention.

METHODS

We performed a scoping literature review to establish the relationship between SM and skin cancer. A literature search was conducted across MEDLINE, Embase, Cochrane Library, Web of Science, and Scopus from January 2000 to June 2023. The included studies discussed SM and its relationship to and effect on skin cancer.

RESULTS

Through the search, 1009 abstracts were initially identified, 188 received full-text review, and 112 met inclusion criteria. The included studies were divided into 7 groupings based on a publication's primary objective: misinformation (n=40, 36%), prevention campaign (n=19, 17%), engagement (n=16, 14%), research (n=12, 11%), education (n=11, 10%), demographics (n=10, 9%), and patient support (n=4, 3%), which were the most common identified themes.

CONCLUSIONS

Through this review, we gained a better understanding of the SM environment addressing skin cancer information, and we gained insight into the best practices by which SM could be used to positively influence the health care information ecosystem.

Can Media Literacy Intervention Improve Fake News Credibility Assessment? A Meta-Analysis

Fake news impacts individuals' behavior and decision-making while also disrupting political processes, perceptions of medical advice, and societal trends. Improving individuals' ability to accurately assess fake news can reduce its harmful effects. However, previous research on media literacy interventions designed for improving fake news credibility assessments has yielded inconsistent results. We systematically collected 33 independent studies and performed a meta-analysis to examine the effects of media literacy interventions on assessing fake news credibility (n = 36,256). The results showed that media literacy interventions significantly improved fake news credibility assessments (Hedges' g = 0.53, 95% confidence interval [0.29-0.78], p < 0.001). Gaming interventions were the most effective intervention form. Conversely, the intervention channel, outcome measurement, and subject characteristics (age, gender, and country development level) did not influence the intervention effects.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial

BACKGROUND

Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas.

OBJECTIVE

This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah.

METHODS

We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign.

RESULTS

The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management.

CONCLUSIONS

Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/50392.

A mobile-based educational intervention on media health literacy: A quasi-experimental study

Background

Health misinformation on social media is a persistent public health concern that requires the proper skill set for interpreting and evaluating accurate information. This study aimed to determine the effects of a mobile app-based educational intervention on media health literacy (MHL) development among Iranian adults.

Methods

This study was a quasi-experimental design conducted in 2022 that included 100 Iranian adults aged 18 to 65 years old. The inclusion criteria for participation were ownership of an Android smartphone, no prior training in MHL, and membership in at least one virtual social media app. As the primary outcome of the study, MHL was assessed using the validated MeHLit questionnaire with two follow-up time points (immediately after program completion and 12 weeks after program completion) in addition to a pre-test. Participants were divided into an experimental group that received the mobile app-based training program and a control group that received none.

Results

The repeated measures test revealed a significant effect of the group-time interaction on the mean MHL score in both the intervention and control groups. Within the intervention group, the follow-up test indicated a significant increase in mean MHL scores for post-test 1 (63.54±12.57) and post-test 2 (65.72±7.97) compared to the pre-test phase (55.14±12.04), with these increases being statistically significant (P<0.001). No significant difference was observed within the control group.

Conclusion

The results of this study suggest that the mobile app-based educational intervention was effective in improving MHL among Iranian adults. These findings highlight the potential of mobile app-based interventions for promoting MHL and addressing health misinformation on social media.

Psychometric properties and factor structure of the appearance-related social media consciousness scale among emerging adults

Appearance-related social media consciousness (ASMC) is the persistent awareness of one's attractiveness on social media. The ASMC Scale, recently developed for use with adolescents (Choukas-Bradley et al., 2020), provides a promising tool for systematically examining ASMC and associations with mental health. The current study examined the psychometric properties of the ASMC Scale among emerging adult men and women. Participants for Study 1 were 428 emerging adults (M age = 21.9) from five Anglophone, industrialized countries (U.S., U.K., Canada, Australia, New Zealand). Results from Study 1 provide evidence that the 13-item ASMC Scale has a unidimensional structure, strong internal consistency, measurement invariance across gender, and convergent validity (i.e., associations with related offline appearance concerns and cognitions) and incremental validity (i.e., associations with depressive symptoms and disordered eating, above and beyond time spent on social media). Participants from Study 2 were 296 U.S. college students (M age = 18.6). Results from Study 2 confirmed the factor structure and further demonstrated the convergent and incremental validity (above and beyond both time spent on social media and offline appearance concerns) of the ASMC Scale. Findings suggest that the ASMC Scale can be used among emerging adults, aiding future research investigating social media experiences and mental health.

Understanding Social Media Literacy: A Systematic Review of the Concept and Its Competences

Nowadays, people spend long periods on social media, ignoring the implications this carries in daily life. In this context, the concept of social media literacy, an emerging concept scarcely developed in the literature, is relevant. This study sought to analyze, descriptively, the main definitions and competences of the concept of social media literacy. The methodology included a systematic search of literature in the databases Web of Science, PubMed, and Scopus between 2010 and 2021, applying filters for English and Spanish, including only scientific articles. A total of 1093 articles were obtained. An article selection process took place, applying the inclusion and exclusion criteria, resulting in a total of 15 articles being selected. The findings indicate that the concept of social media literacy is based on media literacy to then integrate the characteristics and the implications of digital platforms. This is linked to the development of cognitive competences, where critical thinking, socio-emotional competences, and technical competences are fundamental, considering the social context. The development of socio-emotional competences stands out since social media are a frequent place of interaction between people.

A Moderated Mediation Model of Perceived Effect of Fitspiration Images on Self: The Influence of Media Literacy and BMI

The present study investigated the relationship between internal locus of control and the perceived impact of Instagram fitspiration images on the self with media literacy as the mediating role in this relationship. This study also examined the importance of body mass index (BMI) as a moderating factor in the mediated model, where higher BMIs could weaken the relationship between internal locus of control and the perceived effect of fitspiration images mediated through media literacy. A sample of 321 Malaysian university students who were fitspiration viewers filled out a self-report questionnaire assessing internal locus of control, media literacy, perceived effect of fitspiration images on self, body satisfaction and BMI. The data analysis was performed using SPSS PROCESS macro. Results show that internal locus of control is negatively associated with the perceived impact of fitspiration images on self, mediated by media literacy. However, BMI moderates the mediated relationship such that the negative relationship between internal locus of control and the perceived effect of fitspiration images through media literacy does not exert an effect on those with high BMI. These results accentuate the value of incorporating a potential mediator and moderator into the direct relationship between internal locus of control and perceived effect of media ideals on self to provide an enhanced understanding of this process and offer practical insights about the protective role of media literacy and negative effects of high BMI.

Digital interventions for promoting sun protection and skin self-examination behaviors: A systematic review

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A considerable number of digital interventions for skin cancer prevention have been evaluated.

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Most skin cancer digital interventions focus on sun protection-related outcomes.

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Most interventions use web-based digital technology (websites, webpages, mobile apps) rather than videos, emails or text messages alone as the delivery platform.

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Multi-component digital interventions are effective in promoting sun protection and skin self-examination.

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Almost all studies found digital interventions to be equally or more effective compared to non-digital interventions.

The skin cancer incidence rate has been rising, and digital health interventions can promote skin cancer prevention and detection behaviors. A systematic review was conducted to investigate the outcomes of digital interventions that promote sun protection and skin self-examination (SSE). This review examined studies that utilized randomized controlled designs or quasi-experiments, included outcomes related to sun safety or SSE, employed at least one digital platform, and were published in English from January 2000 to October 2020. A total of 62 studies were included in the review. Digital modalities included web-based (e.g., websites) alone (n = 29), mobile-based (e.g., mobile apps) alone (n = 12), game-based (n = 1), emails or text messages alone (n = 8), videos alone (n = 6), social media (n = 3), both text messages and mobile apps (n = 2), or both text messages and video (n = 1). Most studies (n = 44) only evaluated sun protection-related outcomes, seven studies assessed SSE outcomes only, nine studies examined both, and two assessed other related outcomes. Digital interventions are effective compared to non-intervention control conditions in promoting sun safety or SSE. Almost all studies found digital interventions to be equally or more effective compared to non-digital interventions. This review suggests that although the digital interventions varied, they showed promising effects on improving sun protection or SSE outcomes. Future research should include more sophisticated phase-based and rigorous longitudinal research designs, additional investigation of social media and other newer technologies, as well as more detailed reporting of methods and results.

Female university students’ knowledge, attitudes, and behaviours towards sun exposure and the use of artificial tanning devices: the essence of reducing risky behaviours

Aim

To investigate female university students’ knowledge, attitudes, and behaviours towards sun exposure and the use of artificial tanning devices.

Subject and methods

A descriptive correlational survey design using online questionnaires, targeting a population of female university students aged 18–25 from one university in the United Kingdom.

Results

Three hundred and thirty-five students participated (response rate = 26.4%). Students demonstrated average knowledge and good attitude to tanning behaviours, but neither were statistically significantly associated with tanning behaviours. Students showed a history of substantial tanning behaviours, including the use of sunbeds, primarily because having a tanned skin made them look good and thus feel better.

Conclusion

This study has re-affirmed that there is no simple correlation between individuals’ knowledge and attitudes and subsequent sun-tanning behaviours. Feeling good and looking good are critical attributes to female university students’ self-esteem, and these values and beliefs outweigh risk perception of sun-tanning behaviours, and female university students continue to engage in risky tanning behaviours. Focused health promotion activities by public health authorities and higher education institutions should target students’ principal belief of looking good feeling good, as such targeted health promotion may reduce harmful sun tanning behaviours and ultimately mitigate the rising incidence in skin cancers.

New Media Literacy, Health Status, Anxiety, and Preventative Behaviors Related to COVID-19: A Cross-Sectional Study in Taiwan

Internet media may exacerbate public confusion and anxiety about COVID-19. New media health literacy (NMHL) is considered to play a protective role against health-related misinformation from the media for individuals to maintain their health. The current study aims to examine the relationship among Taiwanese adults' NMHL, health status, anxiety, and prevention behaviors during the COVID-19 pandemic. This cross-sectional study was conducted through an online survey, and 342 responses were included in the analysis. The survey tools include Health Status, COVID-19-Related New Media Health Literacy, COVID-19 Anxiety, and COVID-19 Preventive Behaviors. The research showed that both functional and critical prosuming literacy had positive relationships with health status. Functional consumption literacy had a weak negative correlation with COVID-19 anxiety. Furthermore, critical consumption literacy had a positive relationship with COVID-19 preventive behaviors. Therefore, individuals' health, anxiety, and prevention behaviors are affected by different aspects of COVID-19-related new media health literacy. Compared to their consuming media literacy, Taiwanese adults have insufficient prosuming media literacy in regard to COVID-19 health issues.

Behavioural interventions delivered through interactive social media for health behaviour change, health outcomes, and health equity in the adult population

BACKGROUND

Social networking platforms offer a wide reach for public health interventions allowing communication with broad audiences using tools that are generally free and straightforward to use and may be combined with other components, such as public health policies. We define interactive social media as activities, practices, or behaviours among communities of people who have gathered online to interactively share information, knowledge, and opinions.

OBJECTIVES

We aimed to assess the effectiveness of interactive social media interventions, in which adults are able to communicate directly with each other, on changing health behaviours, body functions, psychological health, well-being, and adverse effects. Our secondary objective was to assess the effects of these interventions on the health of populations who experience health inequity as defined by PROGRESS-Plus. We assessed whether there is evidence about PROGRESS-Plus populations being included in studies and whether results are analysed across any of these characteristics.

SEARCH METHODS

We searched CENTRAL, CINAHL, Embase, MEDLINE (including trial registries) and PsycINFO. We used Google, Web of Science, and relevant web sites to identify additional studies and searched reference lists of included studies. We searched for published and unpublished studies from 2001 until June 1, 2020. We did not limit results by language.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), controlled before-and-after (CBAs) and interrupted time series studies (ITSs). We included studies in which the intervention website, app, or social media platform described a goal of changing a health behaviour, or included a behaviour change technique. The social media intervention had to be delivered to adults via a commonly-used social media platform or one that mimicked a commonly-used platform. We included studies comparing an interactive social media intervention alone or as a component of a multi-component intervention with either a non-interactive social media control or an active but less-interactive social media comparator (e.g. a moderated versus an unmoderated discussion group). Our main outcomes were health behaviours (e.g. physical activity), body function outcomes (e.g. blood glucose), psychological health outcomes (e.g. depression), well-being, and adverse events. Our secondary outcomes were process outcomes important for behaviour change and included knowledge, attitudes, intention and motivation, perceived susceptibility, self-efficacy, and social support.

DATA COLLECTION AND ANALYSIS

We used a pre-tested data extraction form and collected data independently, in duplicate. Because we aimed to assess broad outcomes, we extracted only one outcome per main and secondary outcome categories prioritised by those that were the primary outcome as reported by the study authors, used in a sample size calculation, and patient-important.

MAIN RESULTS

We included 88 studies (871,378 participants), of which 84 were RCTs, three were CBAs and one was an ITS. The majority of the studies were conducted in the USA (54%). In total, 86% were conducted in high-income countries and the remaining 14% in upper middle-income countries. The most commonly used social media platform was Facebook (39%) with few studies utilising other platforms such as WeChat, Twitter, WhatsApp, and Google Hangouts. Many studies (48%) used web-based communities or apps that mimic functions of these well-known social media platforms. We compared studies assessing interactive social media interventions with non-interactive social media interventions, which included paper-based or in-person interventions or no intervention. We only reported the RCT results in our 'Summary of findings' table. We found a range of effects on health behaviours, such as breastfeeding, condom use, diet quality, medication adherence, medical screening and testing, physical activity, tobacco use, and vaccination. For example, these interventions may increase physical activity and medical screening tests but there was little to no effect for other health behaviours, such as improved diet or reduced tobacco use (20,139 participants in 54 RCTs). For body function outcomes, interactive social media interventions may result in small but important positive effects, such as a small but important positive effect on weight loss and a small but important reduction in resting heart rate (4521 participants in 30 RCTs). Interactive social media may improve overall well-being (standardised mean difference (SMD) 0.46, 95% confidence interval (CI) 0.14 to 0.79, moderate effect, low-certainty evidence) demonstrated by an increase of 3.77 points on a general well-being scale (from 1.15 to 6.48 points higher) where scores range from 14 to 70 (3792 participants in 16 studies). We found no difference in effect on psychological outcomes (depression and distress) representing a difference of 0.1 points on a standard scale in which scores range from 0 to 63 points (SMD -0.01, 95% CI -0.14 to 0.12, low-certainty evidence, 2070 participants in 12 RCTs). We also compared studies assessing interactive social media interventions with those with an active but less interactive social media control (11 studies). Four RCTs (1523 participants) that reported on physical activity found an improvement demonstrated by an increase of 28 minutes of moderate-to-vigorous physical activity per week (from 10 to 47 minutes more, SMD 0.35, 95% CI 0.12 to 0.59, small effect, very low-certainty evidence). Two studies found little to no difference in well-being for those in the intervention and control groups (SMD 0.02, 95% CI -0.08 to 0.13, small effect, low-certainty evidence), demonstrated by a mean change of 0.4 points on a scale with a range of 0 to 100. Adverse events related to the social media component of the interventions, such as privacy issues, were not reported in any of our included studies. We were unable to conduct planned subgroup analyses related to health equity as only four studies reported relevant data.

AUTHORS' CONCLUSIONS

This review combined data for a variety of outcomes and found that social media interventions that aim to increase physical activity may be effective and social media interventions may improve well-being. While we assessed many other outcomes, there were too few studies to compare or, where there were studies, the evidence was uncertain. None of our included studies reported adverse effects related to the social media component of the intervention. Future studies should assess adverse events related to the interactive social media component and should report on population characteristics to increase our understanding of the potential effect of these interventions on reducing health inequities.

A cluster randomized controlled trial of the SoMe social media literacy body image and wellbeing program for adolescent boys and girls: Study protocol

Youth spend substantial time on social media, which can foster self-critical processes that increase risk of body dissatisfaction, disordered eating, and depressed mood. To date, there have been few investigations of interventions to decrease the negative impacts of social media engagement in adolescent boys and girls. This paper outlines the protocol for a cluster randomized controlled trial (RCT) of a four-lesson social media literacy program that was developed based on pilot results and aims to decrease body dissatisfaction, dietary restraint, and strategies to increase muscles. The RCT will be conducted with grades 7-8 students from Australian secondary schools. Using block randomization, grade levels within schools will be assigned to either the SoMe program (intervention) or health lessons as usual (control). Primary outcomes will be body satisfaction, dietary restraint, and strategies to increase muscles. Secondary outcomes will be self-esteem and depressed mood. Participants will complete assessments on four occasions - baseline, five-weeks post-baseline, and six- and 12-month post-baseline. Analyses will compare outcomes in the intervention compared to the control group. This study will be the first to implement a RCT design to evaluate the impact of a school-based social media literacy program designed to mitigate negative impacts of social media.