Health Organizations’ Use of Facebook for Health Advertising and Promotion

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

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

Utilization of Social Media for the Prevention and Control of HIV/AIDS: A Scoping Review

Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.

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

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

How to Avoid Lower Priority for Smoking Cessation Support Content on Facebook: An Analysis of Engagement Bait

Facebook demotes "engagement bait" content that makes people interact. As a result of this sanctioning, public health content can reach fewer Facebook users. This study aims to determine the negative effect of engagement bait and find alternative techniques. In a three-year period, 791 smoking cessation support content was included (n = 791). The Facebook posts were classified into "engagement bait", "alternative techniques" and control groups. Facebook metrics were compared between the study and control groups. The reach of Facebook page fans was significantly lower in the engagement bait group compared to the control group. On the other hand, the alternative techniques had a significantly lower rate of negative Facebook interactions, as well as significantly higher click rates compared to the control group. This is the first study to reveal the sanctioning of engagement bait on smoking cessation support Facebook posts. "Engagement bait" content has a lower ranking on the Facebook Fans' Newsfeed page. Nevertheless, alternative techniques can circumvent the restrictions on engagement bait. At the same time, alternative techniques can stimulate the click rate and inhibit the rate of negative interactions.

Smokers' Engagement Behavior on Facebook: Verbalizing and Visual Expressing the Smoking Cessation Process

The "processes of change" and "motivational language" are common in smoker Facebook users' comments under smoking cessation support contents. Smokers can combine this verbalization of the smoking cessation process with visual expression when they use comments and Facebook reactions at the same time. The aim of this study was to understand the relationship between processes of change, motivational language, and the Facebook reaction buttons. A total of 821 smokers' comments were analyzed in the current study (n = 821), which responded to image-based smoking cessation support contents. The processes of change and the motivational language used in the investigated comments were identified. These linguistic categories were compared with the usage of reaction buttons. The Facebook users who used the "Haha" reaction button wrote a significantly higher proportion of sustain talk than those who used the "Like" or "Love" reaction buttons. The Facebook users who combined the comment and "Love" reaction wrote significantly more change talk than those who did not utilize these buttons. We suggest that the "Haha" reaction may be a negative indicator, the "Like" reaction may be a neutral indicator, and the "Love" reaction may be a positive engagement indicator in terms of the smoking cessation process during Facebook-based interventions. These results may highlight how to evaluate Facebook reactions relating to smoking cessation support contents.

Use of Live Community Events on Facebook to Share Health and Clinical Research Information With a Minnesota Statewide Community: Exploratory Study

BACKGROUND

Community engagement can make a substantial difference in health outcomes and strengthen the capacity to deal with disruptive public health events such as the COVID-19 pandemic. Social media platforms such as Facebook are a promising avenue to reach the broader public and enhance access to clinical and translational science, and require further evaluation from the scientific community.

OBJECTIVE

This study aims to describe the use of live community events to enhance communication about clinical and health research through a Facebook platform case study (Minnesota [MN] Research Link) with a Minnesota statewide community. We examined variables associated with video engagement including video length and type of posting.

METHODS

From June 2019 to February 2021, MN Research Link streamed 38 live community events on its public Facebook page, MN Research Link. Live community events highlighted different investigators' clinical and health research in the areas of mental health, health and wellness, chronic diseases, and immunology/infectious diseases. Facebook analytics were used to determine the number of views, total minutes viewed, engagement metrics, and audience retention. An engagement rate was calculated by the total number of interactions (likes, shares, and comments) divided by the total length of the live event by the type of live community event.

RESULTS

The 38 live community events averaged 23 minutes and 1 second in duration. The total time viewed for all 38 videos was 10 hours, 44 minutes, and 40 seconds. Viewers' watch time averaged 23 seconds of content per video. After adjusting for video length, promotional videos and research presentations had the highest engagement and retention rates. Events that included audience participation did not have higher retention rates compared to events without audience participation.

CONCLUSIONS

The use of live community events showed adequate levels of engagement from participants. A view time of 23 seconds on average per video suggests that short informational videos engage viewers of clinical and translational science content. Live community events on Facebook can be an effective method of advancing health promotion and clinical and translational science content; however, certain types of events have more impact on engagement than others.

Social media use for health, cultural characteristics, and demographics: A survey of Pakistani millennials

Objective

Over the last 10 years, an extensive body of literature has been produced to investigate the role of social media in health. However, little is known about the impact of cultural characteristics (e.g. masculinity, collectivism, and uncertainty avoidance) on social media use regarding health-related information, especially in developing countries like Pakistan. The present study employed Hofstede’s cultural characteristics framework and uses and gratification theory to examine how Pakistani millennials’ demographic attributes and cultural characteristics are associated with their social media use for health-related information.

Method

An online survey of 722 people aged 18–35 living in Pakistan was conducted in spring 2020 to examine the intensity and frequency of social media use, health-related use of social media, cultural characteristics, and demographic attributes.

Results

Results showed that cultural characteristics—masculinity, collectivism, and uncertainty avoidance—are strongly related with their perceptions of social media importance, usefulness, and perceived ease of access for health-related information even when controlling for demographic characteristics. Age and gender are also significantly associated with their perspectives on social media for health.

Conclusions

We found that communicating and sharing information is the most important motivation for Pakistani millennials to use social media in the area of health with WhatsApp and YouTube being most preferred social media sites for health-related issues.

Social media analytics and reachability evaluation - #Diabetes

BACKGROUND AND AIMS

Diabetes as a lifestyle disorder could be effectively managed by creating awareness among people through social media. Understanding the content of Twitter messages will aid in strategizing health communication about diabetes to the community through Twitter. This study aimed to analyze the content, sentiment, and reachability of diabetes related tweets posted in India.

METHODS

Diabetes related messages from India were collected via Twitter's Application Programming Interface for April 2019. Themes and subthemes of tweet content were identified from randomly selected tweets. The tweets were coded as the source, themes, and subthemes manually. Sentiment analysis of the tweets was done by a lexicon-based approach. The reachability of tweets was assessed based on re-tweet and favorite counts.

RESULTS

Out of 1840 tweets, 57.28% were from organizations and 42.72% were from individuals. The largest proportion of tweet messages were informative (50.76%), followed by promotional tweets (21.52%). The largest proportion of tweets were positive (40.4%) followed by neutral (31.14%) tweets. Among the six major themes, the diabetes story had the highest reachability.

CONCLUSIONS

The outcome of this study would aid public health professionals in planning information dissemination and communication regarding diabetes on Twitter so that the right information reaches a wider population.

Facebook Users' Interactions, Organic Reach, and Engagement in a Smoking Cessation Intervention: Content Analysis

BACKGROUND

Facebook can be a suitable platform for public health interventions. Facebook users can express their reaction to the given social media content in many ways using interaction buttons. The analysis of these interactions can be advantageous in increasing reach and engagement of public health interventions.

OBJECTIVE

This research aimed at understanding how Facebook users' interactions correlate with organic reach and engagement regarding the same smoking cessation support contents.

METHODS

The study population consisted of Facebook users who were reached by a public smoking cessation support page without advertising. We included 1025 nonpaid Facebook posts (N=1025) which used smoking cessation strategies based on a motivational interviewing counseling style. The following data were collected from the "Post Details": the number of people who saw the given nonpaid content (organic reach) which consisted of fan and nonfan reach according to previous "page like" activity; each rate of "engagement indicators" (such as the symbols of "like," "love," "haha," "wow," "sad," "angry"; or other interactions: "shares," "comments," "clicks"); and the rate of negative Facebook interactions (eg, "post hides" or "unlike of page"). Overall, these data were analyzed with the Spearman correlation method.

RESULTS

Surprisingly, we found a significant negative correlation between organic reach and the "like" reaction (rs=-0.418; P<.001). The strongest significant positive correlations of organic reach were observed with the "haha" reaction (rs=0.396; P<.001), comments (rs=0.368; P<.001), and the "love" reaction (rs=0.264; P<.001). Furthermore, nonfan reach correlated positively with "shares" (rs=0.388; P<.001) and clicks (rs=0.135; P<.001), while fan reach correlated positively with the "haha" reaction (rs=0.457; P<.001), comments (rs=0.393; P<.001), and the "love" reaction (rs=0.310; P<.001). Contrary to expectations, the "like" reaction was sharply separated by significant negative correlations from "wow" (rs=-0.077; P=.013), "sad" (rs=-0.120; P<.001), "angry" reactions (rs=-0.136; P<.001), and comments (rs=-0.130; P<.001). Additionally, a high rate of negative Facebook interactions was significantly associated with "wow" (rs=0.076; P=.016) and "sad" reactions (rs=0.091; P=.003).

CONCLUSIONS

This study has shown that it is possible to hypothesize a disadvantage of the "like" reaction and advantages of other interactions (eg, the "haha" reaction or "comments") in content algorithmic ranking on Facebook. In addition, the correlational analysis revealed a need of a further categorization to fan-specific interactions (eg, "haha" or "love" reactions) and nonfan-specific interactions (eg, "shares" and "clicks"). Regarding the direction of the correlations, these findings suggest that some interactions (eg, negative Facebook interactions, "wow," "sad," and "angry" reactions) may decrease the engagement, while other interactions ("like," "love," "haha" reactions, "shares," and "clicks") may increase the engagement during Facebook-based smoking cessation interventions. This hypothesis-generating research offers an important insight into the relationship between organic reach, engagement, and Facebook users' interactions for public health professionals who design Facebook-based interventions.

M-government trust framework: deployment of an empirical study amongst Jordanian youth

Purpose

This paper aims to debate the main factors influencing trust in mobile government (m-government) in the developing country of Jordan. The transformation from government services offered through a government website to services offered via smartphone devices needs further investigation to better understand the factors that might influence citizens’ trust in m-government, in particular, young citizens. This paper presents the concept of m-government and reports on a study of the main predictors affecting citizens’ trust in it. The theoretical framework used is based on the unified theory of acceptance and use of technology (UTAUT).

Design/methodology/approach

A survey study of 510 Jordanian young citizens, who had access to the internet and were smartphone users, investigated the influence of the identified factors on their trust in m-government. The hypotheses testing used multiple regression analysis.

Findings

Contrary to previous claims reported in relation to facilitating conditions, the following predictors: trust in government, word of mouth (WOM), social influence and facilitating conditions were found to be significant factors in predicting Jordanian citizens’ trust in m-government services.

Originality/value

This is one of few studies to investigate what influences trust in m-government by citizens in Jordan. The current research significantly contributes to the literature by incorporating factors from the UTAUT model with personal perception factors to elucidate m-government adoption. The integration of UTAUT with factors such as “WOM”, is a direction that can be followed in research on the adoption of and trust in e-government and m-government by citizens in any social community. This study clearly identities the relationship between m-government trust and the WOM construct, which is rarely discussed in this type of research context. Although the facilitating conditions construct is claimed to be non-significant in the presence of performance expectancy and effort expectancy, the current research shows the importance of including the facilitating conditions construct when considering the topic of m-government trust in Jordan. Finally, this paper provides a foundation for future empirical studies on the adoption of m-government.

Exploring the knowledge of community-based nurses in supporting parents of preterm babies at home: A survey-based study

Aim

This study aimed to investigate the confidence levels, knowledge base and learning needs of community‐based nurses relating to the care of preterm babies and parents, to explore what education is required and in what format.

Design

An online survey methodology was used.

Methods

A 32‐item questionnaire was distributed via social media platforms to community‐based nurses in Australia.

Results

Descriptive analysis was undertaken relating to knowledge base, confidence levels, previous training, learning and resource needs and barriers to education. It was deemed vital to expand confidence and knowledge in this area. Gaps in learning resources were identified and a need for more training in topics such as developmental outcomes, feeding, expected milestones, weight gain, growth trajectories and supporting parents. Online resources were the preferred format to teach key knowledge to community‐based health professionals, tailored to the specific features of preterm babies and support needs of parents.

Personality of Public Health Organizations' Instagram Accounts and According Differences in Photos at Content and Pixel Levels

Organizations maintain social media accounts and upload posts to show their activities and communicate with the public, as individual users do. Thus, organizations’ social media accounts can be examined from the same perspective of that of individual users’ accounts, with personality being one of the perspectives. In line with previous studies that analyzed the personality of non-human objects such as products, stores, brands, and websites, this study analyzed the personality of Instagram accounts of public health organizations. It also extracted features at content and pixel levels from the photos uploaded on the organizations’ accounts and examined how they were related to the personality traits of the accounts. The results suggested that the personality of public health organizations can be summarized as being high in openness and agreeableness but lower in extraversion and neuroticism. Openness and agreeableness were the personality traits associated the most with the content-level features, while extraversion and neuroticism were the ones associated the most with the pixel-level features. In addition, for each of the two traits associated the most with either the content- or pixel- level features, their associations tended to be in opposite directions with one another. The personality traits, except for neuroticism, were predicted from the photo features with an acceptable level of accuracy.

Digital health and management of chronic disease: A multimodal technologies typology

This cross-sectional descriptive study aims to (1) describe the current digital technology (DT) use of people with chronic diseases (CD) by identifying different user profiles and (2) determine whether those profiles have specific characteristics regarding health-related variables and patient-doctor relationship quality (RQ). An online questionnaire assessing the uses of multiple types of DT (the Internet, mobile applications and connected devices) and several dimensions related to health and patient-doctor RQ was completed by 954 individuals living with CD. DT user groups were obtained by k-means cluster analysis and then compared using Mann-Whitney tests. The results show three profiles of DT users: (1) hyperconnected (8.9%, regular users of all DTs), (2) biconnected (19.1%, regular users of the Internet and mobile apps) and (3) hypoconnected (72%, casual users of the Internet only). The hyperconnected and biconnected groups are more empowered, more knowledgeable about their treatment and more committed to their doctors than the hypoconnected group. Nonadherence to treatment, health motivations, self-efficacy for health management and the trust dimension of the patient-doctor RQ did not differ between groups. We conclude by discussing the low use of the most recent technologies in the CD population, although these technologies seem to provide access to health information that empowers patients and leads to a better relationship with their doctors.

Social Media Strategies for Health Promotion by Nonprofit Organizations: Multiple Case Study Design

BACKGROUND

Nonprofit organizations have always played an important role in health promotion. Social media is widely used in health promotion efforts. However, there is a lack of evidence on how decisions regarding the use of social media are undertaken by nonprofit organizations that want to increase their impact in terms of health promotion.

OBJECTIVE

The aim of this study was to understand why and how nonprofit health care organizations put forth social media strategies to achieve health promotion goals.

METHODS

A multiple case study design, using in-depth interviews and a content analysis of each social media strategy, was employed to analyze the use of social media tools by six North American nonprofit organizations dedicated to cancer prevention and management.

RESULTS

The resulting process model demonstrates how social media strategies are enacted by nonprofit organizations to achieve health promotion goals. They put forth three types of social media strategies relative to their use of existing information and communication technologies (ICT)-replicate, transform, or innovate-each affecting the content, format, and delivery of the message differently. Organizations make sense of the social media innovation in complementarity with existing ICT.

CONCLUSIONS

For nonprofit organizations, implementing a social media strategy can help achieve health promotion goals. The process of social media strategy implementation could benefit from understanding the rationale, the opportunities, the challenges, and the potentially complementary role of existing ICT strategies.

Using photos for public health communication: A computational analysis of the Centers for Disease Control and Prevention Instagram photos and public responses

This study aims to explore the use of Instagram by the Centers for Disease Control and Prevention, one of the representative public health authorities in the United States. For this aim, all of the photos uploaded on the Centers for Disease Control and Prevention Instagram account were crawled and the content of them were analyzed using Microsoft Azure Cognitive Services. Also, engagement was measured by the sum of numbers of likes and comments to each photo, and sentiment analysis of comments was conducted. Results suggest that the photos that can be categorized into "text" and "people" took the largest share in the Centers for Disease Control and Prevention Instagram photos. And it was found that the Centers for Disease Control and Prevention's major way of delivering messages on Instagram was to imprint key messages that call for actions for better health on photos and to provide the source of complementary information on text component of each post. It was also found that photos with more and bigger human faces had lower level of engagement than the others, and happiness and neutral emotions expressed on the faces in photos were negatively associated with engagement. The features whose high value would make the photos look splendid and gaudy were negatively correlated with engagement, but sharpness was positively correlated.

Generating Engagement on the Make Healthy Normal Campaign Facebook Page: Analysis of Facebook Analytics

Background

Facebook is increasingly being used as part of mass media campaigns in public health, including the Make Healthy Normal (MHN) campaign in New South Wales, Australia. Therefore, it is important to understand what role Facebook can play in mass media campaigns and how best to use it to augment or amplify campaign effects. However, few studies have explored this.

Objective

This study aimed to investigate usage of and engagement with the MHN Facebook page and to identify influential factors in driving engagement with the page.

Methods

We examined both post-level and page-level analytic data from Facebook from the campaign’s launch in June 2015 to September 2017. For post-level data, we conducted a series of negative binomial regressions with four different outcome measures (likes, shares, comments, post consumers), including some characteristics of Facebook posts as predictors. We also conducted time series analyses to examine associations between page-level outcomes (new page likes or “fans” and number of engaged users) and different measures of exposure to the page (number of unique users reached and total count of impressions) and to television advertising.

Results

Of the 392 posts reviewed, 20.7% (n=81) received a paid boost and 58.9% (n=231) were photo posts. We found that posts that received a paid boost reached significantly more users and subsequently received significantly more engagement than organic (unpaid) posts (P<.001). After adjusting for reach, we found the effect of being paid was incremental for all outcome measures for photos and links, but not videos. There were also associations between day of the week and time of post and engagement, with Mondays generally receiving less engagement and posts on a Friday and those made between 8 AM and 5 PM receiving more. At the page level, our time series analyses found that organic impressions predicted a higher number of new fans and engaged users, compared to paid impressions, especially for women. We also found no association between television advertising and engagement with the Facebook page.

Conclusions

Our study shows that paying for posts is important for increasing their reach, but that page administrators should look to maximize organic reach because it is associated with significantly higher engagement. Once reach is accounted for, video posts do not benefit from being paid, unlike the other post types. This suggests that page administrators should carefully consider how they use videos as part of a Facebook campaign. Additionally, the lack of association between television advertising and engagement suggests that future campaigns consider how best to link different channels to amplify effects. These results highlight the need for ongoing evaluation of Facebook pages if administrators are to maximize engagement.

Factors affecting patients' online health information-seeking behaviours: The role of the Patient Health Engagement (PHE) Model

OBJECTIVE

To identify the variables affecting patients' online health information-seeking behaviours by examining the relationships between patient participation in their healthcare and online health information-seeking behaviours.

METHODS

A cross-sectional survey of Italian chronic patients (N=352) was conducted on patient's online health information-seeking behaviours and patient participation-related variables. Structural equation modeling analysis was conducted to test the hypothesis.

RESULTS

This study showed how the healthcare professionals' ability to support chronic patients' autonomy affect patients' participation in their healthcare and patient's online health information-seeking behaviours. However, results do not confirm that the frequency of patients' online health-information seeking behavior has an impact on their adherence to medical prescriptions.

CONCLUSION

Assuming a psychosocial perspective, we have discussed how patients' engagement - conceived as the level of their emotional elaboration of the health condition - affects the patients' ability to search for and manage online health information.

PRACTICE IMPLICATION

To improve the effectiveness of patients' online health information-seeking behaviours and to enhance the effectiveness of technological interventions in this field, healthcare providers should target assessing and improving patient engagement and patient empowerment in their healthcare. It is important that health professionals acknowledge patients' online health information-seeking behaviours that they discuss the information offered by patients and guide them to reliable and accurate web sources.

Sexual and gender minority's social media user characteristics: Examining preferred health information

The authors examined the influence of social media involvement on health issues in sexual and gender minorities (SGMs). Demographic and technological characteristics of social media users and nonusers were identified, and the influence of social media involvement on these factors was assessed for its potential to influence health information needs and preferences. A survey of 2,274 SGM individuals revealed that age, sexual orientation, number of Internet access points, and use of smartphones predicted levels of social media involvement. Results suggest that a broader range of traditional and nontraditional communication channels is needed to meet a diversity of health information needs in SGMs.

Nurses' online behaviour: lessons for the nursing profession

Social networking is popular online activity; however, like many activities on the internet, there are some privacy risks and concerns associated with its use. Recently, an increasing number of nurses have been censured or asked to appear before regulatory or registering authorities for unprofessional behaviour on social media sites. Problem behaviours identified include: inappropriate content and postings, crossing professional boundaries and breaching patient privacy and confidentiality. This discussion paper aims to give the nursing profession an understanding of how their online behaviour can impact on their professionalism, and how they can avoid problematic situations when using social media (Facebook). This exploratory discussion paper will inform a study researching nurses' online behaviour. Social media is here to stay and nurses need to navigate the complexities of the boundaries between the personal and the professional. Nurses need to learn to balance the growing usefulness of social media, with the legalities and etiquette of the online environment.

Assessing the Viability of Social Media for Disseminating Evidence-Based Nutrition Practice Guideline Through Content Analysis of Twitter Messages and Health Professional Interviews: An Observational Study

Background

Given the high penetration of social media use, social media has been proposed as a method for the dissemination of information to health professionals and patients. This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF).

Objectives

The objectives were to (1) describe the existing social media content on HF, including message content, source, and target audience, and (2) describe the attitude of physicians and registered dietitian nutritionists (RDNs) who care for outpatient HF patients toward the use of social media as a method to obtain information for themselves and to share this information with patients.

Methods

The methods were divided into 2 parts. Part 1 involved conducting a content analysis of tweets related to HF, which were downloaded from Twitonomy and assigned codes for message content (19 codes), source (9 codes), and target audience (9 codes); code frequency was described. A comparison in the popularity of tweets (those marked as favorites or retweeted) based on applied codes was made using t tests. Part 2 involved conducting phone interviews with RDNs and physicians to describe health professionals’ attitude toward the use of social media to communicate general health information and information specifically related to the HF EBNPG. Interviews were transcribed and coded; exemplar quotes representing frequent themes are presented.

Results

The sample included 294 original tweets with the hashtag “#heartfailure.” The most frequent message content codes were “HF awareness” (166/294, 56.5%) and “patient support” (97/294, 33.0%). The most frequent source codes were “professional, government, patient advocacy organization, or charity” (112/277, 40.4%) and “patient or family” (105/277, 37.9%). The most frequent target audience codes were “unable to identify” (111/277, 40.1%) and “other” (55/277, 19.9%). Significant differences were found in the popularity of tweets with (mean 1, SD 1.3 favorites) or without (mean 0.7, SD 1.3 favorites), the content code being “HF research” (P=.049). Tweets with the source code “professional, government, patient advocacy organizations, or charities” were significantly more likely to be marked as a favorite and retweeted than those without this source code (mean 1.2, SD 1.4 vs mean 0.8, SD 1.2, P=.03) and (mean 1.5, SD 1.8 vs mean 0.9, SD 2.0, P=.03). Interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients due to privacy concerns and the fact that the information had to be kept general rather than be tailored for a specific patient and the belief that their patients did not use social media or technology.

Conclusions

Existing Twitter content related to HF comes from a combination of patients and evidence-based organizations; however, there is little nutrition content. That gap may present an opportunity for EBNPG dissemination. Health professionals use social media to gather information for themselves but are skeptical of its value when communicating with patients, particularly due to privacy concerns and misconceptions about the characteristics of social media users.

Please Like Me: Facebook and Public Health Communication

Facebook, the most widely used social media platform, has been adopted by public health organisations for health promotion and behaviour change campaigns and activities. However, limited information is available on the most effective and efficient use of Facebook for this purpose. This study sought to identify the features of Facebook posts that are associated with higher user engagement on Australian public health organisations' Facebook pages. We selected 20 eligible pages through a systematic search and coded 360-days of posts for each page. Posts were coded by: post type (e.g., photo, text only etc.), communication technique employed (e.g. testimonial, informative etc.) and use of marketing elements (e.g., branding, use of mascots). A series of negative binomial regressions were used to assess associations between post characteristics and user engagement as measured by the number of likes, shares and comments. Our results showed that video posts attracted the greatest amount of user engagement, although an analysis of a subset of the data suggested this may be a reflection of the Facebook algorithm, which governs what is and is not shown in user newsfeeds and appear to preference videos over other post types. Posts that featured a positive emotional appeal or provided factual information attracted higher levels of user engagement, while conventional marketing elements, such as sponsorships and the use of persons of authority, generally discouraged user engagement, with the exception of posts that included a celebrity or sportsperson. Our results give insight into post content that maximises user engagement and begins to fill the knowledge gap on effective use of Facebook by public health organisations.

Satisfaction Levels and Factors Influencing Satisfaction With Use of a Social App for Neonatal and Pediatric Patient Transfer Information Systems: A Questionnaire Study Among Doctors

BACKGROUND

The treatment of neonatal and pediatric patients is limited to certain medical institutions depending on treatment difficulty. Effective patient transfers are necessary in situations where there are limited medical resources. In South Korea, the government has made a considerable effort to establish patient transfer systems using various means, such as websites, telephone, and so forth. However, in reality, the effort has not yet been effective.

OBJECTIVE

In this study, we ran a patient transfer information system using a social app for effective patient transfer. We analyzed the results, satisfaction levels, and the factors influencing satisfaction.

METHODS

Naver Band is a social app and mobile community application which in Korea is more popular than Facebook. It facilitates group communication. Using Naver Band, two systems were created: one by the Neonatal Intensive Care Unit and the other by the Department of Pediatrics at Chonbuk National University Children's Hospital, South Korea. The information necessary for patient transfers was provided to participating obstetricians (n=51) and pediatricians (n=90). We conducted a survey to evaluate the systems and reviewed the results retrospectively.

RESULTS

The number of patients transferred was reported to increase by 65% (26/40) obstetricians and 40% (23/57) pediatricians. The time taken for transfers was reported to decrease by 72% (29/40) obstetricians and 59% (34/57) pediatricians. Satisfaction was indicated by 83% (33/40) obstetricians and 89% (51/57) pediatricians. Regarding factors influencing satisfaction, the obstetricians reported communication with doctors in charge (P=.03) and time reduction during transfers (P=.02), whereas the pediatricians indicated review of the diagnosis and treatment of transferred patients (P=.01) and the time reduction during transfers (P=.007).

CONCLUSIONS

The users were highly satisfied and different users indicated different factors of satisfaction. This finding implies that users' requirements should be accommodated in future developments of patient transfer information systems.

Social media-based civic engagement solutions for dengue prevention in Sri Lanka: results of receptivity assessment

This article focuses on a novel social media-based system that addresses dengue prevention through an integration of three components: predictive surveillance, civic engagement and health education. The aim was to conduct a potential receptivity assessment of this system among smartphone users in the city of Colombo, the epicenter of the dengue epidemic in the island country of Sri Lanka. Grounded in Protection Motivation Theory (PMT) and using a convenience sampling approach, the cross-sectional survey assessed perceived severity (PSe), perceived susceptibility (PSu), perceived response efficacy (PRE), perceived self-efficacy (PSE) and intention-to-use (IU) among 513 individuals. The overall receptivity to the system was high with a score of >4.00 on a five-point scale. Participants belonging to younger, better educated and higher income groups reported significantly better perceptions of the efficaciousness of the system, were confident in their ability to use the system, and planned to use it in the future. PMT variables contributed significantly to regression models predicting IU. We concluded that a social media-based system for dengue prevention will be positively received among Colombo residents and a targeted, strategic health communication effort to raise dengue-related threat perceptions will be needed to encourage greater adoption and use of the system.

Beyond traditional advertisements: leveraging Facebook's social structures for research recruitment

Background

Obtaining access to a demographically and geographically diverse sample for health-related research can be costly and time consuming. Previous studies have reported mixed results regarding the potential of using social media-based advertisements to overcome these challenges.

Objective

Our aim was to develop and assess the feasibility, benefits, and challenges of recruiting for research studies related to consumer health information technology (IT) by leveraging the social structures embedded in the social networking platform, Facebook.

Methods

Two recruitment strategies that involved direct communication with existing Facebook groups and pages were developed and implemented in two distinct populations. The first recruitment strategy involved posting a survey link directly to consenting groups and pages and was used to recruit Filipino-Americans to a study assessing the perceptions, use of, and preferences for consumer health IT. This study took place between August and December 2013. The second recruitment strategy targeted individuals with type 2 diabetes and involved creating a study-related Facebook group and asking administrators of other groups and pages to publicize our group to their members. Group members were then directly invited to participate in an online pre-study survey. This portion of a larger study to understand existing health management practices as a foundation for consumer health IT design took place between May and June 2014. In executing both recruitment strategies, efforts were made to establish trust and transparency. Recruitment rate, cost, content of interaction, and characteristics of the sample obtained were used to assess the recruitment methods.

Results

The two recruitment methods yielded 87 and 79 complete responses, respectively. The first recruitment method yielded a rate of study completion proportionate to that of the rate of posts made, whereas recruitment successes of the second recruitment method seemed to follow directly from the actions of a subset of administrators. Excluding personnel time, the first recruitment method resulted in no direct costs, and the second recruitment method resulted in a total direct cost of US $118.17. Messages, posts, and comments received using both recruitment strategies reflected ten themes, including appreciation, assistance, clarification, concerns, encouragement, health information, interest, promotion, solicitations, and support. Both recruitment methods produced mixed results regarding sample representativeness with respect to characteristics such as gender, race, and ethnicity.

Conclusions

The results of the study demonstrate that leveraging the social structures of Facebook for health-related research was feasible for obtaining small samples appropriate for qualitative research but not for obtaining large samples needed for quantitative research. The content of interactions with members of the target population prompted ethical deliberations concerning suitable target communities and appropriate boundaries between researchers and participants. Widespread replication of this method would benefit from a broad discussion among researchers, social media users, social media companies, and experts in research ethics to address appropriate protocols for such interactions.

Using Twitter for breast cancer prevention: an analysis of breast cancer awareness month

Background

One in eight women will develop breast cancer in her lifetime. The best-known awareness event is breast cancer awareness month (BCAM). BCAM month outreach efforts have been associated with increased media coverage, screening mammography and online information searching. Traditional mass media coverage has been enhanced by social media. However, there is a dearth of literature about how social media is used during awareness-related events. The purpose of this research was to understand how Twitter is being used during BCAM.

Methods

This was a cross-sectional, descriptive study. We collected breast cancer- related tweets from 26 September - 12 November 2012, using Twitter’s application programming interface. We classified Twitter users into organizations, individuals, and celebrities; each tweet was classified as an original or a retweet, and inclusion of a mention, meaning a reference to another Twitter user with @username. Statistical methods included ANOVA and chi square. For content analysis, we used computational linguistics techniques, specifically the MALLET implementation of the unsupervised topic modeling algorithm Latent Dirichlet Allocation.

Results

There were 1,351,823 tweets by 797,827 unique users. Tweets spiked dramatically the first few days then tapered off. There was an average of 1.69 tweets per user. The majority of users were individuals. Nearly all of the tweets were original. Organizations and celebrities posted more often than individuals. On average celebrities made far more impressions; they were also retweeted more often and their tweets were more likely to include mentions. Individuals were more likely to direct a tweet to a specific person. Organizations and celebrities emphasized fundraisers, early detection, and diagnoses while individuals tweeted about wearing pink.

Conclusions

Tweeting about breast cancer was a singular event. The majority of tweets did not promote any specific preventive behavior. Twitter is being used mostly as a one-way communication tool. To expand the reach of the message and maximize the potential for word-of-mouth marketing using Twitter, organizations need a strategic communications plan to ensure on-going social media conversations. Organizations may consider collaborating with individuals and celebrities in these conversations. Social media communication strategies that emphasize fundraising for breast cancer research seem particularly appropriate.

Using Facebook and text messaging to deliver a weight loss program to college students

OBJECTIVE

Between 31 and 35% of the college-aged population is overweight or obese, yet few weight loss trials for this population have been conducted. This study examined the feasibility, acceptability, and initial efficacy of a technology-based 8-week weight loss intervention among college students.

DESIGN AND METHODS

Students (N = 52) were randomly assigned to one of the three arms: Facebook (n = 17); Facebook Plus text messaging and personalized feedback (n = 18); Waiting List control (n = 17), with assessments at 4 weeks and 8 weeks (post-treatment). Participants were 20.47 ± 2.19 years old, 86.45 ± 17.11 kg, with a body mass index of 31.36 ± 5.3 kg/m(2) . Participants were primarily female (86.5%), and the sample was racially diverse (57.7% Caucasian, 30.8% African American, 5.8% Hispanic, and 5.7% other races).

RESULTS

The primary outcome was weight loss after 8 weeks (post-treatment); 96.0% of the participants completed this assessment. At 8 weeks, the Facebook Plus group had significantly greater weight loss (-2.4 ± 2.5 kg) than the Facebook (-0.63 ± 2.4 kg) and Waiting List (-0.24 ± 2.6 kg) (both Ps < 0.05). Weight change at 8 weeks was not significantly different between the Facebook and Waiting List groups.

CONCLUSIONS

Results show preliminary efficacy and acceptability of the two active intervention arms (97.0% found the program helpful, 81.3% found the videos/handouts helpful, and 100% would recommend the program to others). Results indicate the potential for an innovative weight loss intervention that uses technology platforms (Facebook and text messaging) that are frequently used and already integrated into the cultural life of college students.