Are Social Networking Sites Making Health Behavior Change Interventions More Effective? A Meta-Analytic Review

Understanding parent perspectives on engagement with online youth-focused mental health programs

OBJECTIVE

Online youth-focused health programs often include parent modules-that equip parents with skills to assist their child in improving their health-alongside youth-specific content. BRAVE Self-Help, an evidence-based program designed for children and teenagers with early signs of anxiety, is a popular Australian program that includes six parent modules. Despite its popularity and proven efficacy, BRAVE Self-Help shares the same challenge as many online self-help programs-that of low participant engagement. Using parents registered in BRAVE Self-Help as 'information rich' participants, we explored (a) factors that influenced parent engagement in online health programs, and (b) their recommendations for enhancing parent engagement.

DESIGN AND OUTCOME MEASURE

We conducted semi-structured interviews with 14 parents registered in BRAVE Self-Help. Data were analysed through reflexive thematic analysis.

RESULTS

Social-, family- and program-related factors drove parents' program engagement and recommendations. Social sub-themes related to the benefits of professional and community support in promoting more engagement. Family sub-themes included difficulties with program engagement due to competing priorities, perceptions that condition severity influenced engagement, and feelings that previously-acquired health knowledge reduced motivation to engage. Program sub-themes included perceived usefulness and ease-of-use.

CONCLUSION

Program designers could target support systems, include flexible delivery options, and use iterative design processes to enhance parent engagement.

The Future of Social Media, Anesthesiology, and the Perioperative Physician

Social media has rapidly developed in the past decade to become a powerful and influential force for patients, physicians, health systems, and the academic community. While the use of social media in health care has produced many positive changes, such as rapid dissemination of information, crowd-sourced sharing of knowledge, learning, and social interaction, social media in health care has also negative effects. Recent examples of negative impacts of social media include rapid and unchecked information dissemination leading to patient misinformation and inadvertent reputational harm for health care professionals due to engaging in controversial topics on public platforms. Members of the anesthesiology community, like other medical specialties, have rapidly adopted social media at many different levels. However, most anesthesiologists, health systems, and academic communities have little education, preparation, and guidelines on optimizing the use of social media technology while minimizing the risks of social media. Anesthesiology has been and will continue to be impacted by the forces of technology and the cultural influences of social media for the foreseeable future. The purpose of this article was to examine the recent history of social media adoption in anesthesiology and perioperative medicine, understand the current impact of social media across our specialty, and consider how the future development of technology and evolving social and cultural dynamic influences of social media will have on anesthesiology over the next quarter century.

Which educational messengers do medical students prefer for receiving healthinformation? Development and psychometrics of using health messengers questionnaire

INTRODUCTION

Individuals vary in their selection of health messengers. This research aimed to construct an instrument to measure the preferences of medical students in selecting health messengers and in the next step to validate the aforementioned questionnaire.

METHOD

This research is a descriptive survey with an approach to construct a questionnaire. The statistical population included all students studying at Shiraz University of Medical Sciences in March to June 2022 in the academic year 2021-2022. 500 participants were involved in the study. To determine the types of health messengers and review the texts, a group of 15 primary items consisting of the 6 components of academic sources (2-items), formal news sources (2-items), mass media (3-items), internet search (2-items), social networks and messenger applications (4-items), and informal conversation (2-items) were compiled. A 4-point scale was developed the content validity of which was confirmed using CVI and CVR method and the reliability index was calculated to be 0.818. Factor analysis was also used to determine the construct validity and factor loading of each item.

RESULTS

The research covers university students in different medical fields. Using factor analysis, together with KMO = 0.810 and Bartlett's sphericity index P < 0.0001, saturation and the suitability of the test were confirmed. Students' preferences based on factor load were social media (28.92%), official and unofficial health sources(10.76%), academic sources (9.08%), internet search (8.18%), and mass media (7.13%), respectively. Among social media, Telegram (0.85) had the highest factor load followed by Instagram (0.79), and WhatsApp (0.71).

CONCLUSION

Medical students are always on the move and naturally prioritize mobile-based methods. They prefer messengers that are free from time and space restrictions. The widespread availability of mobile devices and the ability to search for and access information make it easier to test health information. Therefore, in health policy, attention should be paid to the virtual capabilities, especially mobile-based approaches.

Empowering Healthcare through Precision Medicine: Unveiling the Nexus of Social Factors and Trust

This study investigated the impact of social factors on the acceptance of precision medicine (PM) using a quantitative survey grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. The findings revealed that social influence has a significantly positive effect on PM acceptance, while the influence of social media is found to be insignificant. Performance expectancy emerged as the most influential factor, demonstrating a significant relationship with PM acceptance. Trust plays a crucial moderating role, mitigating the impact of social factors on PM acceptance. While exploring the mediating effects of trust, we identified a significant mediation effect for social influence and performance expectancy on PM acceptance. However, the mediation effect of social media influence is insignificant. These findings highlight the importance of trust in shaping decisions regarding PM acceptance. These findings have significant implications for healthcare practitioners and policymakers aiming to promote the adoption of precision medicine in clinical practice.

Social Media vs. Mass Media: Mitigating the Suspicion of Ulterior Motives in Public Health Communication

Two experiments examined if persuasive effectiveness of health messages varies as a function of the communication channel (Facebook vs. news website), and if so, why. Specifically, we examined perceived ulterior motives of the communicator as an explanation for why public health campaigns may be less effective when conveyed via mass-directed (vs. interpersonal) channels, and further investigated if message recipients' health interest moderates such channel effects, if any. In Study 1 (N = 103), reading a medical news reporter's Facebook post on dental health (vs. a news article consisting of the identical content) lowered the participants' suspicion of ulterior motives of the source, which then promoted message-consistent attitudes and behavioral intention. Such effects, however, emerged only for those more interested in health. Using a different topic (a low-carb, high-fat diet), Study 2 (N = 338) replicated Study 1 findings, confirming the conditional persuasive advantages of social media over mass media as a health campaign channel.

Examining Public Messaging on Influenza Vaccine over Social Media: Unsupervised Deep Learning of 235,261 Twitter Posts from 2017 to 2023

Although influenza vaccines are safe and efficacious, vaccination rates have remained low globally. Today, with the advent of new media, many individuals turn to social media for personal health questions and information. However, misinformation may be rife, and health communications may be suboptimal. This study, therefore, aimed to investigate the public messaging related to influenza vaccines by organizations over Twitter, which may have a far-reaching influence. The theoretical framework of the COM-B (capacity, opportunity, and motivation component of behavior) model was used to interpret the findings to aid the design of messaging strategies. Employing search terms such as "flu jab", "flu vaccine", "influenza vaccine", and '" influenza jab", tweets posted in English and by organizations from 1 January 2017 to 1 March 2023 were extracted and analyzed. Using topic modeling, a total of 235,261 tweets by organizations over Twitter were grouped into four main topics: publicizing campaigns to encourage influenza vaccination, public education on the safety of influenza vaccine during pregnancy, public education on the appropriate age to receive influenza vaccine, and public education on the importance of influenza vaccine during pregnancy. Although there were no glaring pieces of misinformation or misconceptions, the current public messaging covered a rather limited scope. Further information could be provided about influenza and the benefits of vaccination (capability), promoting community, pharmacist-led influenza vaccination, and other avenues (opportunity), and providing greater incentivization and support for vaccination (motivation).

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.

Are Social Media Interventions for Health Behavior Change Efficacious among Populations with Health Disparities?: A Meta-Analytic Review

While prior reviews have identified positive effects of social media interventions for health behavior change generally, it is unclear whether these effects persist in traditionally underrepresented populations that are at disproportionate risk of disease. The current meta-analysis examined the effectiveness of social media interventions for health behavior change among populations with health disparities. We analyzed 17 studies with a cumulative N = 3,561. Social media interventions had a significant moderate-sized effect on behavior change among populations with health disparities (d = 0.303, 95% CI: 0.156, 0.460, p < .001), and there was significant heterogeneity across the studies (Q = 64.48, p < .001, I2 = 75.19). Exploratory moderator analyses revealed larger effects in studies with smaller sample size (p < .05) and those using additional intervention channels, including e-mail and telephone (p < .05). Findings suggest that social media interventions may be a promising intervention tool for stimulating behavior change among populations with health disparities, but several gaps remain in the literature. Public health professionals and other health communicators should further explore ways to increase both the reach and impact of social media interventions among populations with health disparities.

Arranging the fruit basket: A computational approach towards a better understanding of adolescents' diet-related social media communications

This study investigated the contents and linguistic styles that adolescents use in their dietary communications on social media. The main aim of the study was to describe adolescents' social media communication practices with regards to diet, in order to better understand dietary social influences and how to effectively intervene in them. The current study made use of an online communication dataset (N = 72,384 messages) of adolescents in primary and secondary school (N = 1038, 9-16 y/o). We analyzed the message content using tailor-made diet- and health-related dictionaries and LDA topic modeling. The linguistic style of the messages was investigated by assessing the sentiment and underlying psychological dimensions. Further, we used multivariate linear regressions to test how each message dimension was related to message liking, which was considered as an indicator of a message's influence potential regarding peers' dietary behaviors. The results confirmed that adolescents show a preference to discuss neutral-to-unhealthy dietary items most often. No association emerged between message content (i.e., message healthiness and topics) and the number of likes that a message received, while messages with more positive sentiment and higher subjectivity received slightly more likes. Also, our findings confirm that visual dietary content is more often liked than textual descriptions alone. The findings indicate that the content and the healthiness of a message does not explain its popularity among adolescents. Rather, the way how diet-related content is formulated (i.e., in a positive and subjective tone) emerged as a more important predictor for message liking.

When Engagement Leads to Action: Understanding the Impact of Cancer (Mis)information among Latino/a Facebook Users

Latinos/as - the largest minority group in the U.S. - are avid Facebook users, making this an opportune tool to educate on the uptake of cancer prevention and screening behaviors. However, there is a dearth in scholarship exploring how Latinos/as engage with and act upon health content encountered on social media, which may be influenced by cultural values. This qualitatively-driven, mixed-methods study explores how Latinos/as engage with and act upon cancer prevention and screening information (CPSI) on Facebook. During one-on-one, in-depth interviews, participants (n = 20) logged onto their Facebook account alongside the researcher and discussed cancer-related posts they engaged with during the past 12 months. Interview questions included the reasons for engagement, and whether engagement triggered further action. Interviews were analyzed thematically. In parallel, a content analysis of the CPSI posts identified during the interviews was conducted. The majority of CPSI posts participants engaged with contained food-related content and visual imagery. Engagement was most common when individuals had personal relationships to the poster, when posts included videos/images, and when posts contained content promoting the curative properties of popular Latin American foods. Engagement often led to information-seeking and sharing, discussing content with others, and/or changing health behaviors. Findings highlight the importance of adequately contextualizing how cultural values influence the ways in which Latinos/as engage with and act upon CPSI on Facebook, which may lead individuals to bypass evidence-based procedures. Multi-pronged efforts are necessary to adequately leverage social media to empower Latinos/as to partake in behaviors that effectively reduce cancer health disparities.

Online social capital, offline social capital and health: Evidence from China

The fast-developing Internet is changing the way people interact, this new phenomenon helps people build and accumulate online social capital. However, the influence of online social capital on individual health is controversial. Based on the social capital theory, this study examined the effect of online social capital on health in subgroups with different levels of offline social capital. Data from the China Family Panel Studies of 2016 were used (N = 13,910), and the propensity score matching approach was used to address potential endogeneity problems. The results show that offline social capital had significant positive associations with individual health; although online social capital had few effects on individual health overall, significant health effects of online social capital were observed in subgroups with different offline social capital levels. In subgroups with less general trust and neighborhood social capital, more online social capital was associated with less depression; while in subgroups with more neighborhood social capital, more online social capital was associated with an elevated probability of two-week morbidity. Our findings further clarify the relationship between online/offline social capital and individual health. Online social capital can be considered as a supplement of offline social capital when it comes to health promotion, and more online contact should be encouraged when offline social capital of individuals or within the community is scarce.

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.

A theory-based video intervention to enhance communication and engagement in online health communities: two experiments

Background

Online communities and social networking sites have great potential for supporting health behavior change. However, interventions vary greatly in participants’ engagement rates and, consequently, their effectiveness. Theory-based interventions in real-world contexts are needed to further increase engagement and effectiveness.

Methods

We experimentally tested whether a video intervention teaching Self-Determination-Theory-based communication strategies increases need-supportive communication strategy use over one week (Study 1, N = 76) and perceived need support, engagement, and goal attainment in a behavior change intervention supported by a forum-based online community (Study 2, N = 537). In Study 2, participants chose a goal (increasing either fruit or vegetable consumption or increasing moderate or vigorous physical activity) and joined an online community for 2 weeks. Data from both experiments were analyzed with mixed models and follow-up tests.

Results

In Study 1, participants in the intervention but not in the control group showed an increase in the number of need-supportive communication strategies used both immediately and one week after the intervention (condition × time interaction, partial η² = 0.31). In Study 2, participants who watched the intervention video had a higher number of postings and reported a higher subjective forum use frequency (but not a higher number of logins) compared to participants who watched the control video. However, the effect on the subjective forum visit frequency was not robust. There were no intervention effects on perceived need support, goal attainment, or secondary outcomes. The results might be explained by low application of need-supportive communication strategies.

Conclusion

A brief video intervention may be a suitable, low-cost intervention to promote need-supportive communication strategy use, benefitting both engagement and behavior change. Future studies should incorporate additional means to further improve communication strategy uptake and engagement in online communities.

Health Consequences of Online Social Capital among Middle-Aged and Older Adults in China

With the rapid development of Internet techniques in China, more and more Chinese middle-aged and older adults have begun to use the Internet for their daily social interactions, and the resulting online social capital may affect their health. Using data from the Chinese General Social Survey of 2017 (n = 7733, aged 45-90 years old), this study investigated the influence of online social capital on the health of middle-aged and older adults in China, and the Heckman sample selection model was used to address potential sample selection bias in Internet use. The results show that number of online contacts significantly improved the physical health of middle-aged and older adults, while the level of depression was significantly reduced by online closeness of non-specific relationships, but more online interactions may slightly increase their depression. Furthermore, more online contacts were associated with elevated physical health among male, rural, less-educated and middle-aged adults, while more online closeness of non-specific relationships was associated with less depression in almost all subgroups. Online social capital can improve the health of middle-aged and older adults in China, so we should help increase older adults' access to the Internet and improve their Internet skills to give full play to the positive health effect of online social capital. However, it should be alert to the negative health consequences caused by excessive Internet use.

Theory-Based Social and Non-Social Engagement Features in Smoking Cessation Mobile Apps: A Content Analysis

Despite the ubiquity of smartphone ownership and the increasing integration of social engagement features in smoking cessation apps to engage users, the social and non-social engagement features that are present in current smoking cessation apps and the effectiveness of these features in engaging users remain understudied. To fill the gap in the literature, a content analysis of free and paid smoking cessation mobile apps was conducted to examine (a) the presence of social features (i.e., social support, social announcement, and social referencing) and non-social engagement features (e.g., personal environmental changes, goal setting, progress tracking, reinforcement tracking, self-monitoring, and personalized recommendations) and (b) their relationships with user engagement scores measured by the Mobile App Rating Scale. In this study, 28.2% of the smoking cessation apps enable social announcement and 8.1% offered the social support feature. Only two apps provided a social referencing feature (1.3%). No app included reinforcement tracking, with the percentage of other non-social engagement features ranging from 9.4% to 49.0%. Social support (β = 0.30, p < 0.001), social announcement (β = 0.21, p < 0.05), and social referencing (β = 0.18, p < 0.05) were significant predictors of user engagement. Regarding the non-social engagement features, personal environment changes (β = 0.38, p < 0.001), progress tracking (β = 0.18, p < 0.05), and personalized recommendations (β = 0.37, p < 0.001) significantly predicted user engagement. The findings not only contribute to the mobile communication literature by applying and extending the theory-based mobile health apps engagement typology, but also inform the future architecture design of smoking cessation mobile apps.

Social Support and Physical Activity in Older Adults: Identifying Predictors Using Data From the Canadian Longitudinal Study on Aging

This study examined which of nine forms of social support were the strongest predictors of physical activity in older adults, and to what degree these associations were moderated by eight demographic indicators of groups at increased risk of social isolation. Baseline data from 21,491 adults aged 65 and older who were participants of the Canadian Longitudinal Study on Aging were analyzed using multiple regression. Greater social network size, social contact with network members, and participation in community-related activities predicted greater physical activity, whereas being in a domestic partnership and perceiving more tangible support to be available were negatively associated. The strength and direction of these associations varied by sex, living arrangement, and income. Given the findings, various forms of social support should be incorporated in physical activity interventions but tailored to meet the needs of different segments of the aging population.

Using Social Media for the Prevention of Pediatric Burn Injuries: Pilot Design and Usability Study

BACKGROUND

Most pediatric burn injuries are preventable. Social media is an effective method for delivering large-scale messaging and may be useful for injury prevention in this domain.

OBJECTIVE

This study evaluates the feasibility of creating a social media campaign for pediatric burn injury prevention.

METHODS

Ad spots containing a headline, short introduction, and video were created and posted on Facebook and Instagram over 4 months. Ad spots were targeted to parents and caregivers of children in our region with the highest number of burn injuries. We assessed the impact of each ad set using ThruPlays, reach, and video plays.

RESULTS

We created 55 ad spots, with an average length of 24.1 (range 10-44) seconds. We reached 26,496 people during the campaign. The total ThruPlays of the 55 ad spots were 14,460 at US $0.19 per ThruPlay. Ad spots related to home safety had a significantly higher daily ThruPlay rate than those related to fire safety (6.5 vs 0.5 per day; P<.001).

CONCLUSIONS

Social media is a feasible modality for delivering public health messages focused on preventing pediatric burn injuries. Engagement with these ads is influenced by ad presentation and the focus of the underlying injury prevention message.

Behavioral weight loss in emerging adults: Design and rationale for the Richmond Emerging Adults Choosing Health (REACH) randomized clinical trial

BACKGROUND

In the U.S., over 40% of 18-25 year olds meet criteria for overweight or obesity. Yet, no large-scale trials have targeted this age group for behavioral weight loss (BWL). Formative data revealed that existing BWL programs do not meet their unique needs and identified motivation as a fundamental barrier for weight management. The goal of the Richmond Emerging Adults Choosing Health (REACH) trial was to test the efficacy of two mHealth lifestyle interventions specifically focused on enhancing motivation, relative to adapted standard.

METHODS

Participants (N = 381, 18-25 years, body mass index 25-45 kg/m²) will be randomized to 1) adapted BWL (aBWL), 2) aBWL + self-determination theory (aBWL+SDT), or 3) aBWL + behavioral economics (aBWL+BE). All arms will receive a 6-month intervention, delivered via one group session and one individual session, followed by an mHealth platform. Assessments will occur at baseline, 3-months, 6-months (post-treatment) and 12-months (following a no-contact period). The primary aim is to compare weight loss outcomes at 6 months. Secondary aims include changes at 6-months in physical and behavioral cardiometabolic risk factors, as well as psychosocial measures. We will also explore weight loss maintenance, change in hypothesized mediators, and moderators of treatment response.

DISCUSSION

REACH is the first large-scale BWL trial designed specifically for emerging adults. Further, it will be the first trial to compare a lifestyle intervention grounded in self-determination theory to one rooted in behavioral economics. If clinically significant reductions in adiposity are achieved, findings could inform a scalable treatment model to meet the needs of this vulnerable population.

TRIAL REGISTRATION

NCT02736981.

Predictors of Attendance Patterns in a Universal Family-Based Preventive Intervention Program

Achieving sustained engagement in family-based preventive intervention programs is a serious challenge faced by program implementers. Despite the evidence supporting the effectiveness and potential population-level impacts for these programs, their actual impact is limited by challenges around retention of participants. In order to inform efforts to better retain families, it is critical to understand the different patterns of attendance that emerge across the duration of program implementation and the factors that are associated with each attendance pattern. In this study, we identified latent classes of attendance patterns across the seven program sessions of the Strengthening Families Program: For Parents and Youth Ages 10-14 (SFP 10-14). Youth and their parents who attended at least one SFP 10-14 program session together were included in the analysis. Four distinct classes emerged: First-Session Attenders (7%), Early Attenders (9%), Declining-High Attenders (18%), and Consistent-High Attenders (66%). An examination of individual, family, and sociodemographic predictors of class membership revealed that adolescent school bonding predicted families having relatively high attendance, adolescent involvement with deviant peers predicted early dropout, and family low-income status predicted early dropout. Findings point to the need for potential targeted strategies for retaining these groups, such as involving school personnel, employing brief interventions to identify and address barriers at the outset, and leveraging the positive influence of Consistent-High Attenders. Findings also shed light on ways to reach those who may continue to drop out early, such as restructuring program content to address critical material early in the program. This study adds to the growing body of literature that seeks to understand for whom, when, and in which ways program dropout occurs.

Social Media Use for Health Purposes: Systematic Review

Background

Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years.

Objective

This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies.

Methods

The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles.

Results

This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public.

Conclusions

Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.

Effects of New Media Use on Health Behaviors: A Case Study in China

Background:

Mass communication is one of the most important ways in health communication. The emergence of new media has changed the way people acquire health information and then their health behaviors. However, few studies have been conducted about complicated relations between media use and health behaviors under new media conditions and further systematic explanation is needed.

Methods:

A hypothesis model for the influence of WeChat use on health behaviors was constructed to explore the internal influencing mechanism of new media use on health behaviors. An empirical analysis on the internal influencing mechanism of WeChat use on health behaviors was carried out with a survey data consist of 463 young active users on famous online social network sites in China from March to June 2019.

Results:

New media use represented by WeChat has significant positive influence on health behaviors. Individuals who frequently use new media related to health have better health conditions than those who rarely use them. The improvement of health behaviors is mainly attributed to acquisition of health knowledge. Such effect is also mediated by the degree of individuals’ trust in health knowledge.

Conclusion:

This study not only discloses the influencing mechanism of new media use and health knowledge on health behaviors, but also confirms the value of new media in promoting public health communication and public health behaviors. Conclusions provide significant references in decision-making to develop effective guidance of public health.

How Social Media Exposure to Health Information Influences Chinese People's Health Protective Behavior during Air Pollution: A Theory of Planned Behavior Perspective

Haze has become one of the most life-threatening problems in China and affects over one billion Chinese people's health. Chinese people have become more dependent on receiving health information from social media, especially Weibo and WeChat, which shapes their health perceptions and behaviors. To investigate how Chinese people's exposure to health information on social media influenced their health protective behaviors in response to haze, particularly wearing a PM2.5 anti-haze mask, we conducted a longitudinal web-based survey of mainland Chinese. The results from the structural equation modeling showed that (a) attitude and descriptive norm positively mediated the relationships between using Weibo for health information and behavioral intention while descriptive norm negatively mediated the relationship between using WeChat for health information and intention, and that (b) attitude, descriptive norm, and injunctive norm significantly predicted behavioral intention and wearing mask, but perceived behavior control did not. Theoretical and practical implications are discussed.

Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial

INTRODUCTION

Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS.

PURPOSE

To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS.

METHODS

A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures.

CONCLUSIONS

IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.

Relationship Between Internet Use and Change in Health Status: Panel Study of Young Adults

Background

Using the internet for health information is a widespread phenomenon documented in considerable scholarship. Less common, however, is the analysis of panel data to examine how internet use may relate to change in health status over time.

Objective

This study examines whether internet use and internet use related to health are associated with a change in health status among young adults.

Methods

We used a unique panel survey data set collected about young adults’ internet use in 2012 and 2016 (n=384). We applied logistic regression to examine the relationships between sociodemographics, internet experiences, frequency of health-related internet use, and sharing health content online with change in health status over time. We additionally examined the variables characterizing sharing health content online (via Facebook, Twitter, and email) in separate models.

Results

In the second wave, over half (236/384, 61.5%) of the sample used the internet for health at least weekly. Approximately one-third (141/384, 36.7%) used Facebook for health-content sharing, while using Twitter and email for sharing health content were far less frequent (14/384, 3.6%, and 55/384, 14.3%, respectively). A change in health status occurred for 43.0% (165/384) of the sample; 18.5% (71/384) reported an improvement while 24.5% (94/384) reported a decline. Greater frequency of internet use was associated with health decline over time (B=–0.58, P=.02). We also found that frequent health-related internet use was related to enhanced health or maintained health (B=0.58, P=.03). Sharing health content on social media or email, however, was not related to young adults’ health changes.

Conclusions

Young adults exhibit a pattern of using the internet for health that influences their health status. Our finding that frequent health-related internet use may promote improved or maintained health suggests that this type of online activity might also support healthy living.

Can the adoption of health information on social media be predicted by information characteristics?

Purpose

This paper aims to explore the relationship between the characteristics of social media health information and its adoption. The purpose is to identify information characteristics that can be used to estimate the level of health information adoption in advance.

Design/methodology/approach

According to the Information Adoption Model (IAM), the study extracted ten information characteristics from the aspects of information quality and information source credibility. The sample data was collected from the top ten influential health accounts based on the Impact List of Sina Weibo to test the effectiveness of these characteristics in distinguishing information at different levels of adoption. The forecasting of information adoption level is regarded as a binary classification question in the study and support vector machine (SVM) is used to do the research.

Findings

The results indicate that ten information characteristics chosen in this study are related to information adoption. Based on these information characteristics, it is feasible to estimate the level of health information adoption, and the estimation accuracy is relatively high.

Originality/value

A lot of work has been done in previous researches to reveal the factors that influence information adoption. The theoretical contribution of this work is to further discuss how to use the influencing factors to do some predictive work for information adoption. In practice, it will help health information publishers to disseminate high-quality health information more effectively as well as promote the adoption of health information.

Exploring How Media Influence Preventive Behavior and Excessive Preventive Intention during the COVID-19 Pandemic in China

In the context of global fighting against the unexpected COVID-19 pandemic, how to promote the public implementation of preventive behavior is the top priority of pandemic prevention and control. This study aimed at probing how the media would affect the public’s preventive behavior and excessive preventive intention accordingly. Data were collected from 653 respondents in the Chinese mainland through online questionnaires and further analyzed by using partial least squares structural equation modeling (PLS-SEM). Taking risk perception, negative emotions, and subjective norms as mediators, this study explored the impact of mass media exposure and social networking services involvement on preventive behavior and excessive preventive intention. Based on differences in the severity of the pandemic, the samples were divided into the Wuhan group and other regions group for multi-group comparison. The results showed that mass media exposure had a significant positive impact on subjective norms; moreover, mass media exposure could significantly enhance preventive behavior through subjective norms, and social networking services involvement had a significant positive impact on negative emotions; meanwhile, social networking services involvement promoted excessive preventive intention through negative emotions.

The Effectiveness of Interactivity in Improving Mediating Variables, Behaviors and Outcomes of Web-Based Health Interventions: A Meta-Analytic Review

Despite the increasing amount of research investigating health interventions that applies to interactive computer technology, the effect sizes in Cohen's d obtained across these studies range from -0.32 to 1.74. The lack of systematic review of interactive health interventions leaves their overall effectiveness unknown. To address this, a meta-analysis of 67 studies examining the effects of web-based interactive health interventions was conducted. Results indicated that web-based interactive health interventions were effective in general, but the effects were moderated by health topic, theoretical framework, and design of treatment and control groups. The unique advantage of interactivity was small but significant when comparing to health interventions with comparable information in non-interactive version. Theoretical and practical implications of findings were discussed.

Birth Control Connect: A randomized trial of an online group to disseminate contraceptive information

OBJECTIVE

We sought to test whether participation in an online group including IUD users influenced IUD-related knowledge, attitudes, and behavior among IUD non-users, as a proof-of-concept evaluation of information dissemination for less commonly used or novel contraceptives.

STUDY DESIGN

We conducted a blinded, randomized controlled trial on the effect of online communication with IUD users within an online program called Birth Control Connect. Participants were women age 18-45 living in the United States who had never used an IUD. We invited participants randomized to the intervention to join two-week, nine-member discussion groups including four satisfied IUD users and five IUD non-users; we invited control participants to groups including nine IUD non-users. We performed chi-squared tests on IUD knowledge, information-seeking, informational support and use in immediate post-surveys, and t-tests comparing change in IUD attitudes and frequency of logins to discussion groups.

RESULTS

We invited 488 IUD non-users and enrolled them into 70 groups between October 2015 and April 2016. We found increased positive attitudes towards the IUD in the intervention arm (0.65-point increase between pre- and post-surveys, versus 0.05 mean change for control arm, p = 0.03 for hormonal IUD, with a trend in the same direction for the non-hormonal IUD). Informational support also increased, with 70.3% of intervention arm participants self-reporting that they gained a better idea of what the IUD would be like, compared to 51.3% in control arm (p < 0.01). Of intervention participants, 63.3% versus 51.3% of control participants reported gaining new information from their group (p = 0.03). There were no differences in correct responses to knowledge items or information-seeking between groups.

CONCLUSIONS

Online exposure to IUD users increased positive attitudes toward the IUD and informational support for decision-making about the IUD among non-users.

IMPLICATIONS STATEMENT

Online spaces provide a promising environment for the exchange of accurate, useful contraceptive information based on real user experiences. Interventions aiming to harness social communication through structured online conversations (e.g., on existing social media platforms) about user experiences with lesser-known contraceptive methods such as the IUD may be worthwhile.

Understanding Computer-Mediated Support Groups: A Revisit Using a Meta-Analytic Approach

The increasing popularity of computer-mediated support groups (CMSGs) has drawn scholarly attention in recent decades. Fifteen empirical controlled studies have been published since Rains and Young's meta-analysis, showing mixed results, with a large variation of effect sizes ranging from -.77 to 1.33 in Cohen's d. To provide a better understanding of CMSGs, the current study meta-analyzed these 15 newly published studies along with the studies included in Rains and Young's meta-analysis, and tested study design and demographic moderators that have not been examined before. In addition, the study also revisited group size as a moderator and provided updated results with a larger sample size. Theoretical and practical implications of findings are discussed.

Breastfeed4Ghana: Design and evaluation of an innovative social media campaign

Although targeting health behaviour change through social media campaigns has gained traction in recent years, few studies have focused on breastfeeding social media campaigns. Within the context of rising social media utilization and recent declines in exclusive breastfeeding practices in Ghana, we implemented Breastfeed4Ghana, a Facebook‐ and Twitter‐based breastfeeding social media campaign. This study determined feasibility of implementing Breastfeed4Ghana and evaluated its impact on breastfeeding knowledge in Ghana. Key performance indicators of the campaign were monitored on social media platforms, Facebook and Twitter. An online cross‐sectional survey conducted across three time points (n = 451) assessed breastfeeding knowledge, campaign exposure, and understanding and acceptability of Breastfeed4Ghana among Ghanaian adults. Modified Poisson models were used to assess the relationship between campaign exposure and breastfeeding knowledge, adjusting for survey time point, sex, and parenthood status. The campaign acquired 4,832 followers. Based on follower demographics collected from Facebook and Twitter analytics, the target population was successfully reached. Campaign exposure among survey participants was 42.3% and 48.7% at midline and endline, respectively. Campaign acceptability was high (>90%), and >44% of those exposed to the campaign also shared the campaign with others. However, 61.0% of those exposed did not know or could not remember the purpose of the campaign. Campaign exposure was not associated with higher breastfeeding knowledge (APR [95% confidence interval] = 0.96 [0.73, 1.26]). Breastfeed4Ghana was highly feasible. However, campaign understanding yielded mixed findings and may explain the limited impact on breastfeeding knowledge.

Effectiveness of Facebook Groups to Boost Participation in a Parenting Intervention

Although family-based prevention programs have been shown to be effective at reducing adolescent substance use, it is often difficult and costly to recruit and retain parents in programs administered in person. The current study tested whether program engagement and parenting practices could be improved by offering parents in a self-directed family program access to a private Facebook group. Parents of middle school children (N = 103) were recruited through paid Facebook ads to a 5-week self-directed teen substance use prevention program to be completed at home together by parents and their children. Two thirds of parents (N = 72) were randomly assigned to a moderated private Facebook group that provided a forum for parents in the study to interact with each other, and one third (N = 31) were randomized to use the intervention materials without additional support. Relatively few parents participated in the Facebook group and most did not find the experience useful. However, satisfaction with the program assessed 3 months after program completion was high among all parents and most parents engaged with the materials, irrespective of Facebook group assignment. Overall, parents reported significantly lower conflict and more household rules 6 months post-intervention compared to baseline. Parenting practices did not change more among those assigned to the Facebook group than among parents who used the materials on their own. The current findings suggest that providing opportunities for parents to interact online while participating in a self-directed family intervention may not help to increase engagement or improvements in parenting practices, particularly when few parents engage with each other.

The Comparative Effectiveness of Mobile Phone Interventions in Improving Health Outcomes: Meta-Analytic Review

Background

As mobile technology continues expanding, researchers have been using mobile phones to conduct health interventions (mobile health—mHealth—interventions). The multiple features of mobile phones offer great opportunities to disseminate large-scale, cost-efficient, and tailored messages to participants. However, the interventions to date have shown mixed results, with a large variance of effect sizes (Cohen d=−0.62 to 1.65).

Objective

The study aimed to generate cumulative knowledge that informs mHealth intervention research. The aims were twofold: (1) to calculate an overall effect magnitude for mHealth interventions compared with alternative interventions or conditions, and (2) to analyze potential moderators of mHealth interventions’ comparative efficacy.

Methods

Comprehensive searches of the Communication & Mass Media Complete, PsycINFO, Web of Knowledge, Academic Search Premier, PubMed and MEDLINE databases were conducted to identify potentially eligible studies in peer-reviewed journals, conference proceedings, and dissertations and theses. Search queries were formulated using a combination of search terms: “intervention” (Title or Abstract) AND “health” (Title or Abstract) AND “*phone*” OR “black-berr*” (OR mHealth OR “application*” OR app* OR mobile OR cellular OR “short messag*” OR palm* OR iPhone* OR MP3* OR MP4* OR iPod*) (Title or Abstract). Cohen d was computed as the basic unit of analysis, and the variance-weighted analysis was implemented to compute the overall effect size under a random-effects model. Analysis of variance–like and meta-regression models were conducted to analyze categorical and continuous moderators, respectively.

Results

The search resulted in 3424 potential studies, the abstracts (and full text, as necessary) of which were reviewed for relevance. Studies were screened in multiple stages using explicit inclusion and exclusion criteria, and citations were evaluated for inclusion of qualified studies. A total of 64 studies were included in the current meta-analysis. Results showed that mHealth interventions are relatively more effective than comparison interventions or conditions, with a small but significant overall weighted effect size (Cohen d=0.31). In addition, the effects of interventions are moderated by theoretical paradigm, 3 engagement types (ie, changing personal environment, reinforcement tracking, social presentation), mobile use type, intervention channel, and length of follow-up.

Conclusions

To the best of our knowledge, this is the most comprehensive meta-analysis to date that examined the overall effectiveness of mHealth interventions across health topics and is the first study that statistically tested moderators. Our findings not only shed light on intervention design using mobile phones, but also provide new directions for research in health communication and promotion using new media. Future research scholarship is needed to examine the effectiveness of mHealth interventions across various health issues, especially those that have not yet been investigated (eg, substance use, sexual health), engaging participants using social features on mobile phones, and designing tailored mHealth interventions for diverse subpopulations to maximize effects.

Four Dissemination Pathways for a Social Media-Based Breastfeeding Campaign: Evaluation of the Impact on Key Performance Indicators

Background

Social media utilization is on the rise globally, and the potential of social media for health behavior campaigns is widely recognized. However, as the landscape of social media evolves, so do techniques used to optimize campaign dissemination.

Objective

The primary aim of this study was to evaluate the impact of 4 material dissemination paths for a breastfeeding social media marketing campaign in Ghana on exposure and engagement with campaign material.

Methods

Campaign materials (n=60) were posted to a Facebook and Twitter campaign page over 12 weeks (ie, baseline). The top 40 performing materials were randomized to 1 of 4 redissemination arms (control simply posted on each platform, key influencers, random influencers, and paid advertisements). Key performance indicator data (ie, exposure and engagement) were extracted from both Facebook and Twitter 2 days after the material was posted. A difference-in-difference model was used to examine the impact of the dissemination paths on performance.

Results

At baseline, campaign materials received an average (SD) exposure of 1178 (670) on Facebook and 1071 (905) on Twitter (n=60). On Facebook, materials posted with paid advertisements had significantly higher exposure and engagement compared with the control arm (P<.001), and performance of materials shared by either type of influencer did not differ significantly from the control arm. No differences in Twitter performance were detected across arms.

Conclusions

Paid advertisements are an effective mechanism to increase exposure and engagement of campaign posts on Facebook, which was achieved at a low cost.

How does anonymous online peer communication affect prevention behavior? Evidence from a laboratory experiment

While the importance of social networks for health behaviors is well-recognized, relatively little is known regarding the accuracy of anonymous online communication and its impact on health behavior. In 2012, we conducted a laboratory experiment in Boston, Massachusetts with 679 individuals to understand how anonymous online communication affects individual prevention decisions. Participants had to opt for or against investing in prevention over three sessions, each consisting of 15 experimental rounds. In the third session only, participants could share their experiences with a group of 1-3 other anonymous participants after each round. Groups exchanged an average of 16 messages over the 15 rounds of the third session. 70% of messages contained information about the subject's prevention decision and the resulting health outcome. Participants were more likely to communicate when they prevented than when they did not, with prevention failures resulting in the highest probability of sending a message. Nonetheless, receiving an additional message reporting prevention increased the odds a subject would prevent by 32 percent. We find that participants tend to adopt the prevention behavior reported by others, with less weight given to the reported outcomes of prevention, suggesting that social networks may influence behaviors through more than just information provision.

To Retweet or Not to Retweet: Understanding What Features of Cardiovascular Tweets Influence Their Retransmission

Twitter is one of the largest social networking sites (SNSs) in the world, yet little is known about what cardiovascular health related tweets go viral and what characteristics are associated with retransmission. The current study aims to identify a function of the observable characteristics of cardiovascular tweets, including characteristics of the source, content, and style that predict the retransmission of these tweets. We identified a random sample of 1,251 tweets associated with CVD originating from the United States between 2009 and 2015. Automated coding was conducted on the affect values of the tweets as well as the presence/absence of any URL, mention of another user, question mark, exclamation mark, and hashtag. We hand-coded the tweets' novelty, utility, theme, and source. The count of retweets was positively predicted by message utility, health organization source, and mention of user handle, but negatively predicted by the presence of URL and nonhealth organization source. Regarding theme, compared to the tweets focusing on risk factor, tweets on treatment and management predicted fewer retweets while supportive tweets predicted more retweets. These findings suggest opportunities for harnessing Twitter to better disseminate cardiovascular educational and supportive information on SNSs.

Prevalence and correlates of intentional outdoor and indoor tanning among adolescents in the United States: Findings from the FLASHE survey

A body of research has focused on adolescents' indoor tanning behaviors but relatively little is known about the prevalence of adolescents' intentional outdoor tanning (time spent outdoors to get a tan). The present study used data from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health and Eating (FLASHE) cross-sectional survey to examine the prevalence and correlates of intentional outdoor and indoor tanning among adolescents in the United States. Both unadjusted (bivariate) and adjusted (multi-variate) logistic regressions were performed to test the associations between demographic variables, time spent on media (e.g., using computers), emotional status and outdoor or indoor tanning. The overall prevalence of frequent outdoor tanning among adolescents in the U.S. was 15.6% (95% CI 13.8-17.4%) and the rate of indoor tanning in the past 12 months was 3% (95% CI 2.2-3.9). The adjusted odds of intentional outdoor tanning were significantly higher among girls (AOR 2.39, 95% CI 1.75-3.27), Non-Hispanic Whites (AOR 2.85, 95% CI 1.99-4.07), and those who spent more time on cell phones (AOR 1.40, 95% CI 1.25-1.57). The adjusted odds of indoor tanning were significantly higher among those who spent more time on computers (AOR 1.38, 95% CI 1.09-1.74) and cell phones (AOR 1.49, 95% CI 1.19-1.87). This study provides evidence for the relationship between media use and tanning behaviors among adolescents.

Addressing Parents' Vaccine Concerns: A Randomized Trial of a Social Media Intervention

INTRODUCTION

Successful strategies are needed to address parental vaccine hesitancy, a significant public health issue. The study objective was to assess whether an Internet-based platform with vaccine information and interactive social media components improved parents' vaccine-related attitudes.

STUDY DESIGN

A three-arm RCT.

SETTING/PARTICIPANTS

The study was conducted in a large Colorado integrated healthcare organization. Parents were enrolled during September 2013 through October 2015 and followed through November 2016; data were analyzed in 2017. Parents, recruited during pregnancy, were given a survey about vaccine-related attitudes at enrollment (i.e., baseline) and when their child was aged 3-5 months and 12-15 months (Timepoints 1 and 2, respectively). Parental vaccine hesitancy was assessed at baseline.

INTERVENTION

Study participants were randomized to the following: a study website with vaccine information and social media components (VSM arm); a website with vaccine information only (VI); or usual care.

MAIN OUTCOME MEASURES

Change in parental vaccine attitudes over time by baseline degree of vaccine hesitancy.

RESULTS

Among 1,093 study participants, 945 (86.5%) completed all three surveys. Comparing baseline with Timepoint 1 among vaccine-hesitant parents, the VSM and VI arms were associated with significant improvements in attitudes regarding vaccination benefits compared to usual care (VSM mean change 0.23 on a 5-point scale, 95% CI=0.05, 0.40, VI mean change 0.22, 95% CI=0.04, 0.40). Comparing baseline with Timepoint 2 among hesitant parents, the VSM and VI arms were also associated with significant reductions in parental concerns about vaccination risks compared to usual care (VSM mean change -0.37, 95% CI= -0.60, -0.14, VI mean change -0.31, 95% CI= -0.55, -0.07). Self-efficacy around vaccine decision making also improved among vaccine-hesitant parents. No intervention effect was observed among parents not vaccine-hesitant at baseline.

CONCLUSIONS

Among vaccine-hesitant parents, an Internet-based intervention improved parents' attitudes about vaccines.

TRIAL REGISTRATION

This study was registered at www.clinicaltrials.gov NCT01873040.

Reach and Acceptability of a Mobile Reminder Strategy and Facebook Group Intervention for Weight Management in Less Advantaged Adolescents: Insights From the PRALIMAP-INÈS Trial

Background

Although information and communication technology interventions appear to be a promising means of reducing the health inequality gap in overweight and obesity prevention, research on information and communication technology interventions is lacking outside the Anglo-Saxon world.

Objective

The aim of this study was to assess the reach and acceptability of 2 information and communication technology interventions delivered as part of a French nutritional program: an SMS text messaging (short message service, SMS) attendance-reminder for collective sessions strategy and a Facebook challenge group.

Methods

This study sample comprised 262 socially less advantaged overweight adolescents aged between 13 and 18 years. The information and communication technology interventions were carried out during the 2013-2014 academic year in 33 French state-run schools. For the SMS attendance-reminder for collective sessions strategy, at the start of the academic year, adolescents were asked to give their mobile number. SMS attendance-reminders were sent shortly before each of the 5 collective sessions. For the Facebook challenge group, adolescents were invited to join a closed Facebook group in which challenges on physical activity and on diet were posted weekly. Process data and 2 sets of face-to-face interviews were also used to interpret participation rates and access to Facebook. Appreciation for both interventions was evaluated by a questionnaire at the end of the academic year.

Results

Of the recruited adolescents, 79.0% (207/262) gave their mobile number, reflecting high access to a mobile phone. Giving a number was significantly more likely for girls (odds ratio [OR] 2.1, 95% CI 1.1-3.9; P=.02) and adolescents in a vocational or general high school as opposed to middle school (OR 1.0, 95% CI 0.4-2.7; OR 0.2, 95% CI 0.1-0.5; P<.001). Indicating a mobile number at the start of the year was not significantly associated with participation in collective sessions. Of the adolescents seen at the start-of-year face-to-face interviews, 78.1% (153/196) declared an interest in the Facebook challenge group, which implies having a Facebook account or being able to have access to one. However, only 21 adolescents went through the process of joining the group. Although there was satisfaction with the Facebook group among the participants, the low participation rate in the Facebook group does not allow conclusions to be drawn with confidence.

Conclusions

The results are in line with the claim that using information and communication technologies in health programs is unlikely to widen health inequalities. However, in this population of French adolescents, mobile phone strategies seem more adapted to a high school context, and caution should be exercised with a younger audience. Although there is positive appreciation of the SMS attendance-reminders and a Facebook intervention is initially highly appealing to less advantaged adolescents, no evidence of impact could be demonstrated. These results highlight the difficulty in assessing the impact of specific interventions in complex health programs.

Trial Registration

Clinicaltrials.gov NCT01688453; https://clinicaltrials.gov/ct2/show/NCT01688453 (Archived by WebCite at http://www.webcitation.org/6yy6EQ0SM)

How Is Marijuana Vaping Portrayed on YouTube? Content, Features, Popularity and Retransmission of Vaping Marijuana YouTube Videos

The purpose of the study is to investigate how vaping marijuana, a novel but emerging risky health behavior, is portrayed on YouTube, and how the content and features of these YouTube videos influence their popularity and retransmission. A content analysis of vaping marijuana YouTube videos published between July 2014 to June 2015 (n = 214) was conducted. Video genre, valence, promotional and warning arguments, emotional appeals, message sensation value, presence of misinformation and misleading information, and user-generated statistics, including number of views, comments, shares, likes and dislikes, were coded. The results showed that these videos were predominantly pro-marijuana-vaping, with the most frequent videos being user-sharing. The genre and message features influenced the popularity, evaluations, and retransmission of vaping marijuana YouTube videos. Theoretical and practical implications are discussed.

Web-based Social Media Intervention to Increase Vaccine Acceptance: A Randomized Controlled Trial

BACKGROUND

Interventions to address vaccine hesitancy and increase vaccine acceptance are needed. This study sought to determine if a Web-based, social media intervention increases early childhood immunization.

METHODS

A 3-arm, randomized controlled trial was conducted in Colorado from September 2013 to July 2016. Participants were pregnant women, randomly assigned (3:2:1) to a Web site with vaccine information and interactive social media components (VSM), a Web site with vaccine information (VI), or usual care (UC). Vaccination was assessed in infants of participants from birth to age 200 days. The primary outcome was days undervaccinated, measured as a continuous and dichotomous variable.

RESULTS

Infants of 888 participants were managed for 200 days. By using a nonparametric rank-based analysis, mean ranks for days undervaccinated were significantly lower in the VSM arm versus UC (P = .02) but not statistically different between the VI and UC (P = .08) or between VSM and VI arms (P = .63). The proportions of infants up-to-date at age 200 days were 92.5, 91.3, and 86.6 in the VSM, VI, and UC arms, respectively. Infants in the VSM arm were more likely to be up-to-date than infants in the UC arm (odds ratio [OR] = 1.92; 95% confidence interval [CI], 1.07-3.47). Up-to-date status was not statistically different between VI and UC arms (OR = 1.62; 95% CI, 0.87-3.00) or between the VSM and VI arms (OR = 1.19, 95% CI, 0.70-2.03).

CONCLUSIONS

Providing Web-based vaccine information with social media applications during pregnancy can positively influence parental vaccine behaviors.

Technology Interventions to Manage Food Intake: Where Are We Now?

PURPOSE OF REVIEW

This review describes the state-of-the-art for dietary assessment using smartphone apps and digital technology and provides an update on the efficacy of technology-mediated interventions for dietary change.

RECENT FINDINGS

Technology has progressed from apps requiring entry of foods consumed, to digital imaging to provide food intake data. However, these methods rely on patients being active in data collection. The automated estimation of the volume and composition of every meal consumed globally is years away. The use of text messaging, apps, social media, and combinations of these for interventions is growing and proving effective for type 2 diabetes mellitus (T2DM). Effectiveness of text messaging for obesity management is improving and multicomponent interventions show promise. A stand-alone app is less likely to produce positive outcomes and social media is relatively unexplored. A concentrated effort will be needed to progress digital dietary assessment. Researcher-designed technology programs are producing positive outcomes for T2DM but further research is needed in the area of weight management.