A review of social media analytic tools and their applications to evaluate activity and engagement in online sexual health interventions

RETRACTED ARTICLE: Social media analytics and their applications to evaluate an activity in online health interventions using CRITIC and TOPSIS techniques

The usage of social media is increasing by leaps and bounds in our day-to-day lives. It affects daily routines and brings a lot of change in different departments like health and education systems during the COVID-19 pandemic. Healthcare research and practice have been significantly impacted by the astounding growth of social media. Social media are changing health information management in several ways, from offering appropriate ways to enhance healthcare professional contact and share health-related knowledge and experience to facilitating the development of innovative medical research and wisdom. Social media analytics (SMAs) are efficient and effective interaction instruments that can be useful for both patients and clinicians in health interventions. Moreover, a significant portion of those involved in clinical practices (such as clinicians, professional colleges, and departments of health) are unaware of the importance of social media, its potential applications in their daily lives, as well as the possible consequences and how these will be handled. In the presented study, we proposed MCDM-based approaches known as "Criteria Importance Through Inter Correlation" (CRITIC) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) in order to identify the effective alternative among several options and make a better decision. After extracting features from the literature review, we choose six significant and relevant features and assign weights to them using CRITIC techniques while utilizing the TOPSIS technique to rank the alternatives based on their performance values. After the implementation of both methods and evaluation procedure, it is determined that the alternative with the highest score is placed at the top and called the "best alternative," while the alternative with the lowest score is placed at the bottom and called the worst alternative. Finally, we suggest a variety of research initiatives and new research areas where the aforementioned procedures become extremely useful in evaluating SMAs and their uses in online health interventions.

Online Cognitive-Behavioral Therapy-Based Nutritional Intervention via Instagram for Overweight and Obesity

BACKGROUND/OBJECTIVES

Obesity is a multifactorial chronic disease treated through lifestyle modifications, pharmacotherapy, and surgery. With the rise of social media, platforms like Instagram have become tools for lifestyle interventions. This study evaluated the impact of a cognitive-behavioral-therapy-based nutritional intervention via Instagram on body weight, eating behavior, and mental health in individuals with overweight and obesity.

METHODS

A 5-week online intervention delivered daily nutritional, cognitive, and behavioral content via a private Instagram account using live sessions, reels, feed posts, polls, and stories. Standardized dietary plans were sent by e-mail. Self-reported weight and waist circumference and questionnaires on eating behavior, self-esteem, stress, and anxiety were collected. Engagement and interaction were measured through comments, likes, number of followers, story retention, participation in live sessions, and direct messages.

RESULTS

The final sample included 66 participants (63 women), 27 with overweight and 39 with obesity, and a mean age of 40.5 ± 10.6 years. After the intervention, body weight decreased by 1.1 kg, while waist circumference remained unchanged. Participants with obesity showed significant improvements in binge eating, uncontrolled eating, self-esteem, stress, and anxiety, while those with overweight showed improvements in binge eating and stress. Weight loss was associated with reduced binge eating and lower cognitive restriction, while lower uncontrolled eating was related to decreased emotional eating, anxiety, and stress. Additionally, participation in live sessions was associated with reduced binge eating.

CONCLUSIONS

This online intervention via Instagram was effective in improving weight loss, eating behavior, and mental health symptoms in participants with overweight and obesity.

Brief video training for suicide prevention in veterans: A randomized controlled trial of VA S.A.V.E

INTRODUCTION

VA S.A.V.E. (Signs; Ask; Validate; Encourage/Expedite) is a gatekeeper training developed by the Department of Veterans Affairs (VA) that teaches individuals to identify and assist veterans at risk for suicide. Although VA S.A.V.E. has been widely disseminated, rigorous evaluation is lacking.

METHODS

In a pilot randomized controlled trial of a brief, video-based version of VA S.A.V.E., individuals were recruited through Facebook, randomized to VA S.A.V.E. versus an attention control condition, and completed 6-month follow-up. A subgroup (n = 15) completed interviews. We used a mixed methods framework to integrate quantitative and qualitative findings.

RESULTS

Among 214 participants, 61% were spouses/partners of veterans and 77% had prior suicide exposure. Sixty-seven percent (n = 68) of VA S.A.V.E. participants watched the entire video, and satisfaction and usability were highly rated. At 6-month follow-up, compared to the control group, the VA S.A.V.E. group had a higher proportion of participants use each gatekeeper behavior (66.7%-84.9% vs. 44.4%-77.1%), and used significantly more total gatekeeper behaviors (2.3 ± 0.9 vs. 1.8 ± 1.0; p = 0.01). Interviews supported positive reactions, learning, and behavior change from VA S.A.V.E.

CONCLUSION

VA S.A.V.E. merits further investigation into its effectiveness as a brief, scalable gatekeeper training for suicide prevention in veterans.

Online public health promotion at the local level: An evaluation of four local authority-led marketing campaigns

Objective

Local authority-led online campaigns offer the possibility of targeted health promotion to connect local services and residents. This study assesses the evidence for medium (e.g., click-trhoughs) and high (off-line behaviour change) levels of public engagement with four local authority-led campaigns across a variety of public health promotions (sexual health, weight loss, and vaccination), online marketing approaches (social media marketing, search engine marketing, and programmatic marketing) and target demographics (language, gender, age, income, ethnicity) undertaken by a London borough local authority.

Methods

Employing quasi-experimental and observational study designs, engagement with local health services during the course of the campaigns was evaluated. The first three campaigns were evaluated based on an interrupted time series model of intervention assessment comparing outcome variables of interest during the campaign to periods before and after the campaign period. The results of the fourth campaign, an observational case-study, are discussed using descriptive statistics only.

Results

The analyses of the high engagement data for two of the three campaigns statistically assessed clearly supported the effectiveness of the campaigns. While the effect of high engagement could not be determined in the other two campaigns, they provide data that may be useful in online campaign design.

Conclusions

The evidence assessed in this study across a variety of platforms, health promotion initiatives, and population targets suggests that local authority-led online marketing campaigns for health promotion may be useful for increasing participation in public health programmes.

Using social media analysis to study population dietary behaviours: A scoping review

BACKGROUND

The rapid adoption and sustained use of social media globally has provided researchers with access to unprecedented quantities of low-latency data at minimal costs. This may be of particular interest to nutrition research because food is frequently posted about and discussed on social media platforms. This scoping review investigates the ways in which social media is being used to understand population food consumption, attitudes and behaviours.

METHODS

The peer-reviewed literature was searched from 2003 to 2021 using four electronic databases.

RESULTS

The review identified 71 eligible studies from 25 countries. Two-thirds (n = 47) were published within the last 5 years. The USA had the highest research output (31%, n = 22) and Twitter was the most used platform (41%, n = 29). A diverse range of dataset sizes were used, with some studies relying on manual techniques to collect and analyse data, whereas others required the use of advanced software technology. Most studies were conducted by disciplines outside health, with only two studies (3%) being conducted by nutritionists.

CONCLUSIONS

It appears the development of methodological and ethical frameworks as well as partnerships between experts in nutrition and information technology may be required to advance the field in nutrition research. Moving beyond traditional methods of dietary data collection may prove social media as a useful adjunct to inform recommended dietary practices and food policies.

Adaptive Content Tuning of Social Network Digital Health Interventions Using Control Systems Engineering for Precision Public Health: Cluster Randomized Controlled Trial

BACKGROUND

Social media has emerged as an effective tool to mitigate preventable and costly health issues with social network interventions (SNIs), but a precision public health approach is still lacking to improve health equity and account for population disparities.

OBJECTIVE

This study aimed to (1) develop an SNI framework for precision public health using control systems engineering to improve the delivery of digital educational interventions for health behavior change and (2) validate the SNI framework to increase organ donation awareness in California, taking into account underlying population disparities.

METHODS

This study developed and tested an SNI framework that uses publicly available data at the ZIP Code Tabulation Area (ZCTA) level to uncover demographic environments using clustering analysis, which is then used to guide digital health interventions using the Meta business platform. The SNI delivered 5 tailored organ donation-related educational contents through Facebook to 4 distinct demographic environments uncovered in California with and without an Adaptive Content Tuning (ACT) mechanism, a novel application of the Proportional Integral Derivative (PID) method, in a cluster randomized trial (CRT) over a 3-month period. The daily number of impressions (ie, exposure to educational content) and clicks (ie, engagement) were measured as a surrogate marker of awareness. A stratified analysis per demographic environment was conducted.

RESULTS

Four main clusters with distinctive sociodemographic characteristics were identified for the state of California. The ACT mechanism significantly increased the overall click rate per 1000 impressions (β=.2187; P<.001), with the highest effect on cluster 1 (β=.3683; P<.001) and the lowest effect on cluster 4 (β=.0936; P=.053). Cluster 1 is mainly composed of a population that is more likely to be rural, White, and have a higher rate of Medicare beneficiaries, while cluster 4 is more likely to be urban, Hispanic, and African American, with a high employment rate without high income and a higher proportion of Medicaid beneficiaries.

CONCLUSIONS

The proposed SNI framework, with its ACT mechanism, learns and delivers, in real time, for each distinct subpopulation, the most tailored educational content and establishes a new standard for precision public health to design novel health interventions with the use of social media, automation, and machine learning in a form that is efficient and equitable.

TRIAL REGISTRATION

ClinicalTrials.gov NTC04850287; https://clinicaltrials.gov/ct2/show/NCT04850287.

Social media-based interventions for adults with obesity and overweight: a meta-analysis and meta-regression

Social isolation and loneliness are growing public health concerns in adults with obesity and overweight. Social media-based interventions may be a promising approach. This systematic review aims to (1) evaluate the effectiveness of social media-based interventions on weight, body mass index, waist circumference, fat, energy intake and physical activity among adults with obesity and overweight and (2) explore potential covariates on treatment effect. Eight databases, namely, PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus PsycINFO and ProQuest, were searched from inception until December 31, 2021. The Cochrane Collaboration Risk of Bias Tool and Grading of Recommendations, Assessment, Development and Evaluation criteria evaluated the evidence quality. Twenty-eight randomised controlled trials were identified. Meta-analyses found that social media-based interventions had small-to-medium significant effects on weight, BMI, waist circumference, body fat mass and daily steps. Subgroup analysis found greater effect in interventions without published protocol or not registered in trial registries than their counterparts. Meta-regression analysis showed that duration of intervention was a significant covariate. The certainty of evidence quality of all outcomes was very low or low. Social media-based interventions can be considered an adjunct intervention for weight management. Future trials with large sample sizes and follow-up assessment are needed.

A randomized controlled trial of social media interventions for risky drinking among adolescents and emerging adults

PURPOSE

Alcohol use among adolescents and emerging adults is an important public health issue requiring prevention approaches. Herein, we describe outcomes from a randomized controlled trial testing the efficacy of group-based social media interventions targeting risky drinking among youth.

PROCEDURES

Using social media advertisements to screen potential participants, we recruited 955 youth (ages 16-24) reporting recent risky drinking. After completing a baseline assessment, participants were randomized to 8-week secret Facebook group conditions: Social Media Intervention + Incentives for engagement, Social Media Intervention only, and attention-placebo control. Electronic coaches trained in motivational interviewing facilitated interaction in intervention groups. Primary outcomes include past 3-month alcohol use and consequences over 3-, 6-, and 12-month follow-ups. Secondary outcomes include other drug use, consequences, and impaired driving. We also measured intervention engagement and acceptability.

RESULTS

The interventions were well-received, with significantly greater acceptability ratings and engagement in the SMI+I condition relative to other groups. In adjusted analyses, there were no significant differences between interventions and control on alcohol-related outcomes, with all groups showing reductions. Regarding secondary outcomes (70.4% used other drugs), compared to control, the incentivized group reduced other drug use, consequences, and cannabis-impaired driving; the non-incentivized group did not significantly differ from the control condition.

CONCLUSIONS

Among this predominantly poly-substance using sample, findings were mixed, with significant effects of the incentivized social media intervention on drug (but not alcohol) outcomes. Future studies are needed to further refine social media-delivered interventions to reduce alcohol and other drug use.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02809586; University of Michigan HUM#00102242.

Adaptation and Dissemination of a National Cancer Institute HPV Vaccine Evidence-Based Cancer Control Program to the Social Media Messaging Environment

Social media offers a unique opportunity to widely disseminate HPV vaccine messaging to reach youth and parents, given the information channel has become mainstream with 330 million monthly users in the United States and 4.2 billion users worldwide. Yet, a gap remains on how to adapt evidence-based vaccine interventions for the in vivo competitive social media messaging environment and what strategies to employ to make vaccine messages go viral. Push-pull and RE-AIM dissemination frameworks guided our adaptation of a National Cancer Institute video-based HPV vaccine cancer control program, the HPV Vaccine Decision Narratives, for the social media environment. We also aimed to understand how dissemination might differ across three platforms, namely Instagram, TikTok, and Twitter, to increase reach and engagement. Centering theory and a question-answer framework guided the adaptation process of segmenting vaccine decision story videos into shorter coherent segments for social media. Twelve strategies were implemented over 4 months to build a following and disseminate the intervention. The evaluation showed that all platforms increased following, but Instagram and TikTok outperformed Twitter on impressions, followers, engagement, and reach metrics. Although TikTok increased reach the most (unique accounts that viewed content), Instagram increased followers, engagement, and impressions the most. For Instagram, the top performer, six of 12 strategies contributed to increasing reach, including the use of videos, more than 11 hashtags, COVID-19 hashtags, mentions, and follow-for-follow strategies. This observational social media study identified dissemination strategies that significantly increased the reach of vaccine messages in a real-world competitive social media messaging environment. Engagement presented greater challenges. Results inform the planning and adaptation considerations necessary for transforming public health HPV vaccine interventions for social media environments, with unique considerations depending on the platform.

Culturally Tailored and Community-Based Social Media Intervention to Promote Organ Donation Awareness among Asian Americans: "Heart of Gold"

Organ donation disparities among ethnic minorities have persisted for decades, especially among Asian Americans (AAs). AAs represent a substantial proportion of the national transplant waitlist but have historically had the lowest organ donation rate in the United States. Community based and culturally tailored (CBCT) interventions are needed to increase donor designation within AA communities. In collaboration with local AA organizations and representatives and national partners, we developed a culturally and linguistically tailored video using a family appeal to promote donor designation among AAs. The video was distributed on social media platforms in two stages from February 17 to September 17, 2021 and tracked Reaches, Impressions, Views, and Engagements as part of a larger evaluation. The results revealed higher social media activities and engagements on Facebook than on Instagram with and without paid advertisements, although the paid approach yielded 5 to 16 times higher viewer engagement. Over six months, the video reached 36,845 AAs and gained 53,308 Impressions, 20,139 Views, 2,455 Engagements, and 232 visits to the organ donation registration page. The findings indicated Facebook and CBCT approaches as effective communication strategies to potentially raise AAs' organ donation awareness, especially among AA females over 45 years of age. Implications and limitations are discussed.

Technology-Delivered Intervention Strategies to Bolster HIV Testing

Since the beginning of the HIV epidemic, there have been more than 75 million cases. Currently, there about 1.2 million living with HIV in the USA. Despite current testing recommendations, test rates continue to be suboptimal. Investigators have studied the use of digital technology to promote HIV testing, especially among high-risk populations. PURPOSE OF REVIEW: This non-systematic review provides an overview of the scientific research between 2015 and 2020 focused on the use of digital technology to bolster HIV testing and suggests novel technologies for exploration. RECENT FINDINGS: A total of 40 studies were included in the review that span a wide range of available technology. Studies effectively increased HIV testing among study participants. Generally, participants in the intervention/exposure groups had significantly higher rates of HIV test uptake compared to participants in the comparison groups at study follow-up. For a variety of reasons (e.g., differences in ways the technologies were used and study design), no digital tool clearly performed better than others, but each have the capacity to increase outreach and self-testing. An exploration of the potential use of nascent technologies is also discussed, as well as the authors' experiences using a number of these technologies in our research.

Is Fun For Wellness Engaging? Evaluation of User Experience of an Online Intervention to Promote Well-Being and Physical Activity

Online well-being interventions demonstrate great promise in terms of both engagement and outcomes. Fun For Wellness (FFW) is a novel online intervention grounded in self-efficacy theory and intended to improve multidimensional well-being and physical activity through multi-modal methods. These strategies include capability-enhancing opportunities, learning experiences such as games, video vignettes, and self-assessments. RCT studies have suggested that FFW is efficacious in improving subjective and domain-specific well-being, and effective in improving mental health, physical health, physical activity, and self-efficacy in United States. adults who are overweight and in the general population. The present study uses qualitative and quantitative user experience data collected during two RCT trials to understand and evaluate engagement with FFW, its drivers, and its outcomes. Results suggest that FFW is enjoyable, moderately engaging, and easy to use; and contributes to positive outcomes including skill development and enhanced confidence, for both overweight individuals and the general adult population. Drivers of engagement appear to include rewards, gamification, scenario-based learning, visual tracking for self-monitoring, ease of use and simple communications, and the entertaining, interactive nature of program activities. Findings indicate that there are opportunities to streamline and simplify the experience. These results can help improve FFW and contribute to the science of engagement with online interventions designed to improve well-being.