An Academic Healthcare Twitter Account: The Mayo Clinic Experience

Examining the Effectiveness of Social Media for the Dissemination of Research Evidence for Health and Social Care Practitioners: Systematic Review and Meta-Analysis

BACKGROUND

Social media use has potential to facilitate the rapid dissemination of research evidence to busy health and social care practitioners.

OBJECTIVE

This study aims to quantitatively synthesize evidence of the between- and within-group effectiveness of social media for dissemination of research evidence to health and social care practitioners. It also compared effectiveness between different social media platforms, formats, and strategies.

METHODS

We searched electronic databases for articles in English that were published between January 1, 2010, and January 10, 2023, and that evaluated social media interventions for disseminating research evidence to qualified, postregistration health and social care practitioners in measures of reach, engagement, direct dissemination, or impact. Screening, data extraction, and risk of bias assessments were carried out by at least 2 independent reviewers. Meta-analyses of standardized pooled effects were carried out for between- and within-group effectiveness of social media and comparisons between platforms, formats, and strategies. Certainty of evidence for outcomes was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework.

RESULTS

In total, 50 mixed-quality articles that were heterogeneous in design and outcome were included (n=9, 18% were randomized controlled trials [RCTs]). Reach (measured in number of practitioners, impressions, or post views) was reported in 26 studies. Engagement (measured in likes or post interactions) was evaluated in 21 studies. Direct dissemination (measured in link clicks, article views, downloads, or altmetric attention score) was analyzed in 23 studies (8 RCTs). Impact (measured in citations or measures of thinking and practice) was reported in 13 studies. Included studies almost universally indicated effects in favor of social media interventions, although effect sizes varied. Cumulative evidence indicated moderate certainty of large and moderate between-group effects of social media interventions on direct dissemination (standardized mean difference [SMD] 0.88; P=.02) and impact (SMD 0.76; P<.001). After social media interventions, cumulative evidence showed moderate certainty of large within-group effects on reach (SMD 1.99; P<.001), engagement (SMD 3.74; P<.001), and direct dissemination (SMD 0.82; P=.004) and low certainty of a small within-group effect on impacting thinking or practice (SMD 0.45; P=.02). There was also evidence for the effectiveness of using multiple social media platforms (including Twitter, subsequently rebranded X; and Facebook), images (particularly infographics), and intensive social media strategies with frequent, daily posts and involving influential others. No included studies tested the dissemination of research evidence to social care practitioners.

CONCLUSIONS

Social media was effective for disseminating research evidence to health care practitioners. More intense social media campaigns using specific platforms, formats, and strategies may be more effective than less intense interventions. Implications include recommendations for effective dissemination of research evidence to health care practitioners and further RCTs in this field, particularly investigating the dissemination of social care research.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022378793; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378793.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/45684.

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.

Social media and academic surgical research dissemination

Academic research dissemination has evolved tremendously throughout the 20th and early 21st centuries. With the advent of new technology and remote communication, the fast and efficient sharing of ideas has spread worldwide and has been appropriately embraced by academic surgical researchers. The use of social media by surgeons has expanded our ability to share hypotheses and published works that lead to higher degrees of collaboration than previously possible. The strengths of social media use for research dissemination in surgery include immediate collaboration on a global scale, faster dissemination of results previously hindered by the publishing process, open peer review from a wider audience, and enhancing the experience of academic meetings. However, social media use for research dissemination is not perfect and is hindered by lack of author verification, public misinterpretation, and lack of standardized enforceable professional guidelines. To combat these potential pitfalls, surgical societies should prioritize specific and intervenable guidelines for surgeons regarding the appropriate use of social media for research dissemination.

Mediterranean Diet Social Network Impact along 11 Years in the Major US Media Outlets: Thematic and Quantitative Analysis Using Twitter

Background: Media outlets influence social attitudes toward health. Thus, it is important that they share contents which promote healthy habits. The Mediterranean diet (MedDiet) is associated with lower cardiovascular disease risk. Analysis of tweets has become a tool for understanding perceptions on health issues. Methods: We investigated tweets posted between January 2009 and December 2019 by 25 major US media outlets about MedDiet and its components as well as the retweets and likes generated. In addition, we measured the sentiment analysis of these tweets and their dissemination. Results: In total, 1608 tweets, 123,363 likes and 48,946 retweets about MedDiet or its components were analyzed. Dairy (inversely weighted in MedDiet scores) accounted for 45.0% of the tweets (723/1608), followed by nuts 19.7% (317/1608). MedDiet, as an overall dietary pattern, generated only 9.8% (157/1608) of the total tweets, while olive oil generated the least number of tweets. Twitter users’ response was quantitatively related to the number of tweets posted by these US media outlets, except for tweets on olive oil and MedDiet. None of the MedDiet components analyzed was more likely to be liked or retweeted than the MedDiet itself. Conclusions: The US media outlets analyzed showed reduced interest in MedDiet as a whole, while Twitter users showed greater interest in the overall dietary pattern than in its particular components.

Social Media as a Means to Disseminate and Advocate Cardiovascular Research: Why, How, and Best Practices

The use of Twitter or other social media platforms for research can transcend current limitations in the dissemination of research and present new opportunities for research networking by connecting researchers, clinicians, policymakers, the public, and other stakeholders on a global scale. As social media influence continues to expand, it becomes increasingly important for cardiovascular researchers to employ social media strategies to increase the impact of their research work, for the ultimate goal of improved outcomes for patients living with or at risk for cardiovascular diseases. Altmetrics are novel metrics that track the attention that scholarly outputs are receiving in non-traditional sources such as in the news, blogs, and social media posts. These alternative metrics record research dissemination beyond traditional journal citation indices, while also predicting and even promoting future citations. This review outlines various methods of how social media can be used to disseminate research, guidance on how to develop a social media portfolio for consideration of academic promotion, and some best practices for promoting one’s research work.

Understanding the "Social" in "Social Media". An Analysis of Twitter Engagement of Pulmonary and Critical Care Fellowship Programs

Background: Social media is ubiquitous as a tool for collaboration, networking, and dissemination. However, little is known about use of social media platforms by pulmonary and critical care medicine fellowship programs.

Objective: We identify and characterize pulmonary and critical care fellowship programs using Twitter and Instagram, as well as the posting behaviors of their social media accounts.

Methods: We identified all adult and pediatric pulmonary, critical care medicine (CCM), and combined pulmonary and critical care medicine (PCCM) programs in the United States using the Electronic Residency Application Service. We searched for Twitter profiles for each program between January 1, 2018, and September 30, 2018. Tweets and Twitter interactions were classified into the following three types: social, clinical, or medical education (MedEd) related. We collected data about content enhancements of tweets, including the use of pictures, graphics interchange format or videos, hashtags, links, and tagging other accounts. The types of tweets, content enhancement characteristics, and measures of engagement were analyzed for association with number of followers.

Results: We assessed 341 programs, including 163 PCCM, 36 adult CCM, 20 adult pulmonary, 67 pediatric CCM, and 55 pediatric pulmonary programs. Thirty-three (10%) programs had Twitter accounts. Of 1,903 tweets by 33 of the 341 programs with Twitter accounts, 476 (25%) were MedEd related, 733 (39%) were clinical, and 694 (36%) were social. The median rate of tweets per month was 1.65 (interquartile range [IQR], 0.4-6.65), with 55% programs tweeting more than monthly. Accounts tweeting more often had significantly more followers than those tweeting less frequently (median, 240 followers; 25-75% IQR, 164-388 vs. median, 107 followers; 25-75% IQR, 13-188; P = 0.006). Higher engagement with clinical and social Twitter interactions (tweets, retweets, likes, and comments) was associated with more followers but not for the MedEd-related Twitter interactions. All types of content enhancements (pictures, graphics interchange format/videos, links, and tagging) were associated with a higher number of followers, except for hashtags.

Conclusion: Despite the steadily increasing use of social media in medicine, only 10% of the pulmonary and critical care fellowship programs in the United States have Twitter accounts. Social and clinical content appears to gain traction online; however, additional evaluation is needed on how to effectively engage audiences with MedEd content.

Analysis of Twitter Activity and Engagement From Annual Meetings of the Society for Vascular Surgery and the Society of Interventional Radiology

BACKGROUND

Medical societies such as the Society for Vascular Surgery (SVS) and the Society of Interventional Radiology (SIR) have been encouraging the use of social media at annual meetings by establishing unique meeting hashtags (eg. #VAM19, #SIR19ATX). These two specialties have similar number of active physicians and share procedural interests. We set forth to understand differences in Twitter activity and engagement by analyzing Twitter outputs from the vascular annual meeting (VAM) and the interventional radiology annual meeting (IRAM) in 2019.

METHODS

Tweets with "#VAM19" and "#SIR19ATX" from 30 days before and 30 days after respective meetings were collected. Proportion of distinct Twitter users relative to total number of meeting attendees, number of posts per user, number of hashtags per post, and number of engagement metrics (likes, replies, and retweets) were collected for comparison. As for the top 100 most liked tweets, specialty-related hashtags were categorized into identity, diversity, education, procedure, and medical care, and the authors of these tweets were also identified for comparison. Student's t-test* and Fisher's Exact^⁎⁎ were utilized for analysis.

RESULTS

A total of 362 and 1944 tweets were collected from the VAM and IRAM in 2019. There was no difference in proportion of active Twitter users relative to total number of meeting attendees between the VAM (7.5%) and IRAM (7.7%). Average number of posts per user from the VAM and IRAM showed no significant difference. However, tweets related to IRAM had significantly higher number of hashtags per post (2.67±1.96) than ones related to VAM (1.78±1.26) (P < 0.0001*). Additionally, these tweets on average received significantly higher number of likes (P < 0.0001*), retweets (P < 0.0001*), and replies (P < 0.0001*) than ones related to the VAM. Specialty-related hashtags from the 100 most liked tweets showed significantly greater proportion of hashtags associated with specialty identity (4% vs 28.6%, P < 0.0001**), diversity (2.9% vs 8.0%, p=0.0268**), and education (1.1% vs 9.1%, p=0.0004**) in tweets related to the IRAM whereas the proportion of hashtags associated with procedure and medical care was similar between the two meetings. Lastly, the 100 most liked tweets were authored by trainees (p=0.005*) and official societies (p=0.003*) in significantly greater proportion in IRAM whereas academic institutions/training hospitals authored in significantly greater proportion (p=0.004*) from the VAM. Contributions from attending physician users to the 100 most liked tweets were similar between the two meetings.

CONCLUSION

Analysis of Twitter activity centered around #VAM19 and #SIR19ATX indicates that there was no significant difference in proportion of Twitter users relative to meeting attendees and average number of posts per user. However, tweets with #SIR19ATX had significantly higher number of hashtags per post and had greater level of engagement than ones with #VAM19. The top 100 most liked tweets from the two meetings differed in proportion of hashtags related to specialty identity, diversity, and education, as well as proportion of contributing authors identified as trainees, official societies, and academic institutions/training hospitals. These data should help the SVS and its members to establish a more directed social media effort to facilitate its use during national gatherings.

General Audience Engagement With Antismoking Public Health Messages Across Multiple Social Media Sites: Comparative Analysis

BACKGROUND

Public health organizations have begun to use social media to increase awareness of health harm and positively improve health behavior. Little is known about effective strategies to disseminate health education messages digitally and ultimately achieve optimal audience engagement.

OBJECTIVE

This study aims to assess the difference in audience engagement with identical antismoking health messages on three social media sites (Twitter, Facebook, and Instagram) and with a referring link to a tobacco prevention website cited in these messages. We hypothesized that health messages might not receive the same user engagement on these media, although these messages were identical and distributed at the same time.

METHODS

We measured the effect of health promotion messages on the risk of smoking among users of three social media sites (Twitter, Facebook, and Instagram) and disseminated 1275 health messages between April 19 and July 12, 2017 (85 days). The identical messages were distributed at the same time and as organic (unpaid) and advertised (paid) messages, each including a link to an educational website with more information about the topic. Outcome measures included message engagement (ie, the click-through rate [CTR] of the social media messages) and educational website engagement (ie, the CTR on the educational website [wCTR]). To analyze the data and model relationships, we used mixed effects negative binomial regression, z-statistic, and the Hosmer-Lemeshow goodness-of-fit test.

RESULTS

Comparisons between social media sites showed that CTRs for identical antitobacco health messages differed significantly across social media (P<.001 for all). Instagram showed the statistically significant highest overall mean message engagement (CTR=0.0037; 95% CI 0.0032-0.0042), followed by Facebook (CTR=0.0026; 95% CI 0.0022-0.0030) and Twitter (CTR=0.0015; 95% CI 0.0013-0.0017). Facebook showed the highest as well as the lowest CTR for any individual message. However, the message CTR is not indicative of user engagement with the educational website content. Pairwise comparisons of the social media sites differed with respect to the wCTR (P<.001 for all). Messages on Twitter showed the lowest CTR, but they resulted in the highest level of website engagement (wCTR=0.6308; 95% CI 0.5640-0.6975), followed by Facebook (wCTR=0.2213; 95% CI 0.1932-0.2495) and Instagram (wCTR=0.0334; 95% CI 0.0230-0.0438). We found a statistically significant higher CTR for organic (unpaid) messages (CTR=0.0074; 95% CI 0.0047-0.0100) compared with paid advertisements (CTR=0.0022; 95% CI 0.0017-0.0027; P<.001 and P<.001, respectively).

CONCLUSIONS

Our study provides evidence-based insights to guide the design of health promotion efforts on social media. Future studies should examine the platform-specific impact of psycholinguistic message variations on user engagement, include newer sites such as Snapchat and TikTok, and study the correlation between web-based behavior and real-world health behavior change. The need is urgent in light of increased health-related marketing and misinformation on social media.

Evaluation of the Sexual Health Behaviors of Black Male Adolescents and Young Adults Through Social Media Platforms: Web-Based Survey Study

Background

Social media platforms such as Facebook, Instagram, and Twitter, which have millions of users who interact and communicate every day, have been effective in promoting sexual health interventions and in disseminating reproductive health education. They have also been shown to be useful in health promotion and have been used to track several key metrics (eg, comments, posts) among users of all demographics. However, there is a lack of research on the impact and reach of these social media platforms as a community-based tool for disseminating sexual health information and for increasing engagement among Black adolescents and young adults, which is a targeted high-risk population.

Objective

The purpose of this study was to determine the social media platforms and banner advertisements that affected engagement among Black male adolescents and young adults in participating in web-based health surveys.

Methods

A web-based survey was conducted from March 2019 to July 2019 to assess sexual health and health behaviors in a convenience sample of Black male adolescents and young adults in the age range of 18-24 years (N=170). Social media metrics from Facebook, Instagram, and Twitter were monitored. This cross-sectional survey comprised several categories, including basic personal information, drug-related risk behaviors, health care, sexual reproductive health questions, attitudes, norms, and perceived control, mental health, violence-related risk behaviors, and social media preferences.

Results

Social media advertisements on the Black Male Opinion survey reached approximately 146,412 individuals. Our primary finding of the web-based survey engagement was that referral (eg, group chat, indirect social media sharing) led to as the greatest proportion of recruitment, with Twitter and YouTube as the preferred sites to receive sexual health information.

Conclusions

Recognizing the variety of technologies being used among Black male young adults and adolescents can help the community, researchers, and health care providers understand the web-based engagement of this high-risk population. This information may also promote culturally sensitive, customized marketing on sexual health information for this population.

Technological, Organizational, and Environmental Factors Influencing Social Media Adoption by Hospitals in Switzerland: Cross-Sectional Study

BACKGROUND

Social media platforms are important tools for hospitals. These platforms offer many potential benefits in various areas of application for hospitals to connect and interact with their stakeholders. However, hospitals differ immensely in their social media adoption. There are studies that provide initial findings on individual factors influencing social media adoption by hospitals, but there is no comprehensive and integrated model.

OBJECTIVE

This study aimed to develop a comprehensive model of social media adoption by hospitals in the context of the Swiss health care system and to test the model with empirical data from Switzerland.

METHODS

To develop our model, we applied the general technology-organization-environment framework of organizational technology adoption and adapted it to the specific context of social media adoption by hospitals in Switzerland. To test our model, we collected empirical data on all 283 hospitals in Switzerland and identified the accounts they operate on 7 different social media platforms (Facebook, Google+, Twitter, Instagram, LinkedIn, XING, and YouTube). We tested the hypotheses of our model by means of binary logistic regression (dependent variable: platform adoption) and negative binomial regression (dependent variable: number of different platforms adopted).

RESULTS

Our general model on social media adoption received broad support. Overall, hospitals in Switzerland are more likely to adopt social media if they have a higher share of patients with voluntary health insurance or have a higher patient volume. In contrast, they are less likely to operate their own social media accounts if they are associated with a hospital network. However, some hypotheses of our model received only partial support for specific social media platforms; for instance, hospitals in Switzerland are more likely to adopt XING if they provide an educational program and are more likely to adopt LinkedIn if they are located in regions with higher competition intensity.

CONCLUSIONS

Our study provides a comprehensive model of social media adoption by hospitals in Switzerland. This model shows, in detail, the factors that influence hospitals in Switzerland in their social media adoption. In addition, it provides a basic framework that might be helpful in systematically developing and testing comprehensive models of social media adoption by hospitals in other countries.

Healthcare practitioners' views of social media as an educational resource

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® (17%), and Instagram® (17%) were the most frequently accessed social media platforms. Nearly 85% agreed or strongly agreed that social media can be an effective tool for educational purposes. Among those who had social media platforms, 43.0% use them for educational purposes. Pinterest® (30%), Facebook® (22%), LinkedIn® (16%), and Twitter® (14%) were most frequently used for education. About 50% of respondents had limited or no access to social media at work. Administrators, those with unlimited and limited work access, and respondents aged 20-29 and 30-39 years were more likely to agree that social media is an educational tool (OR: 3.41 (95% CI 1.31 to 8.84), 4.18 (95% CI 2.30 to 7.60), 1.66 (95% CI 1.22 to 2.25), 4.40 (95% CI 2.80 to 6.92), 2.14 (95% CI 1.53 to 3.01) respectively). Residents, physicians, and those with unlimited access were less likely to agree with allowing social media access at work for educational purposes only. Healthcare practitioners frequently utilize social media, and many believe it can be an effective educational tool in healthcare.

Effect of Promotion via Social Media on Access of Articles in an Academic Medical Journal: A Randomized Controlled Trial

PURPOSE

To study the effect of a planned social media promotion strategy on access of online articles in an established academic medical journal.

METHOD

This was a single-masked, randomized controlled trial using articles published in Mayo Clinic Proceedings, a large-circulation general/internal medicine journal. Articles published during the months of October, November, and December 2015 (n = 68) were randomized to social media promotion (SoMe) using Twitter, Facebook, and LinkedIn or to no social media promotion (NoSoMe), for 30 days (beginning with the date of online article publication). Journal website visits and full-text article downloads were compared for 0-30 and 31-60 days following online publication between SoMe versus NoSoMe using a Wilcoxon rank-sum test.

RESULTS

Website access of articles from 0 to 30 days was significantly higher in the SoMe group (n = 34) compared with the NoSoMe group (n = 34): 1,070 median downloads versus 265, P < .001. Similarly, full-text article downloads from 0-30 days were significantly higher in the SoMe group: 1,042 median downloads versus 142, P < .001. Compared with the NoSoMe articles, articles randomized to SoMe received a greater number of website visits via Twitter (90 vs 1), Facebook (526 vs 2.5), and LinkedIn (31.5 vs 0)-all P < .001.

CONCLUSIONS

Articles randomized to SoMe were more widely accessed compared with those without social media promotion. These findings show a possible role, benefit, and need for further study of a carefully planned social media promotion strategy in an academic medical journal.

Using social media to disseminate research in infection prevention, hospital epidemiology, and antimicrobial stewardship

Social media, prevention of healthcare-associated infections (HAIs) and antimicrobial stewardship (ASP) each impact every area of medicine. Independently, each have power to change medicine, however, synergistically, the impact could be transformative. Given the profound clinical, financial, and public health impact of infection prevention and antimicrobial stewardship combined with the incomplete uptake of best practices, multimodal strategies employing social media are critical to increase the speed and reach of research. This review discusses the strategic utilization of online communication platforms to increase the dissemination of critical publications.

Altmetric Analysis of Contemporary Iranian Medical Journals

BACKGROUND

Altmetrics is a newly emerging scholarly tool measuring online attention surrounding scientific research outputs. With respect to increasing demand of disseminating research findings on the World Wide Web, this study aims to analyze the altmetric statues of Iranian medical journals.

METHODS

On February 27, 2019, the list of Iranian medical journals extracted from http://journals.research.ac.ir/ and consequently altmetric data token out from Altmetric database (Altmetric LLP, London, UK). The science mapping done via keyword co-occurrence, co-citation and co-authorship, network analysis using the VOSviewer. The Pearson coefficient was then employed for the correlation analysis using R.

RESULTS

Among a total of 104 journals, 7518 articles were mentioned in Altmetric data resources (Mean: 72.28, Confidence Level (95.0%): 16.8), total mentions were 27577 (Mean: 265.16, Confidence Level (95.0%): 79.9). Considering the total mentions of articles, International Journal of Preventive Medicine achieved the first rank, followed by Journal of Research in Medical Sciences and Iranian Journal of Public Health. Notably, Twitter was the most popular altmetric resource followed by Facebook and news outlets. Tweets were generally from the United States and United Kingdom. Among top 5% popular Iranian medical articles multiple sclerosis, cancer, and anxiety was hot topics.

CONCLUSIONS

Iranian biomedical journal editors and research scientists needs to be more dynamic in World Wide Web using social media, post-publication peer review tools, Stack Exchange (Q and A) sites, research highlight tools, Wikipedia, and etc. In spite, more attention to the concept of evidence-based policymaking, by Iranian government along with the health policymakers seems necessary.

Areas of Interest and Stigmatic Attitudes of the General Public in Five Relevant Medical Conditions: Thematic and Quantitative Analysis Using Twitter

BACKGROUND

Twitter is an indicator of real-world performance, thus, is an appropriate arena to assess the social consideration and attitudes toward psychosis.

OBJECTIVE

The aim of this study was to perform a mixed-methods study of the content and key metrics of tweets referring to psychosis in comparison with tweets referring to control diseases (breast cancer, diabetes, Alzheimer, and human immunodeficiency virus).

METHODS

Each tweet's content was rated as nonmedical (NM: testimonies, health care products, solidarity or awareness and misuse) or medical (M: included a reference to the illness's diagnosis, treatment, prognosis, or prevention). NM tweets were classified as positive or pejorative. We assessed the appropriateness of the medical content. The number of retweets generated and the potential reach and impact of the hashtags analyzed was also investigated.

RESULTS

We analyzed a total of 15,443 tweets: 8055 classified as NM and 7287 as M. Psychosis-related tweets (PRT) had a significantly higher frequency of misuse 33.3% (212/636) vs 1.15% (853/7419; P<.001) and pejorative content 36.2% (231/636) vs 11.33% (840/7419; P<.001). The medical content of the PRT showed the highest scientific appropriateness 100% (391/391) vs 93.66% (6030/6439; P<.001) and had a higher frequency of content about disease prevention. The potential reach and impact of the tweets related to psychosis were low, but they had a high retweet-to-tweet ratio.

CONCLUSIONS

We show a reduced number and a different pattern of contents in tweets about psychosis compared with control diseases. PRT showed a predominance of nonmedical content with increased frequencies of misuse and pejorative tone. However, the medical content of PRT showed high scientific appropriateness aimed toward prevention.

Analysis of highly tweeted dental journals and articles: a science mapping approach

Aim We aimed to rank dental journals according to the number of Twitter mentions related to their articles. We set out to analyse and visualise the bibliometric characteristics of highly tweeted articles.Methods Twitter mentions were extracted from the Altmetric database. Bibliometric data were obtained from the Web of Science and analysed by VOSviewer software. Hotspots among highly tweeted articles visualised by keyword co-occurrence network analysis. Bibliographic coupling network analysis was used to find the most influential journals, institutions and countries.Results A total of 20,520 Twitter accounts which shared 93,776 tweets related to 23,686 articles from 91 journals were analysed. The British Dental Journal had the highest number of Twitter mentions related to dental articles. Children, dental caries, and periodontal disease were the hottest topics among the 134 highly tweeted dental articles. @The_BDJ had the highest number of tweets related to dental articles, followed by @Dddent2 and @gary_takacs. @TheBDA had the highest number of followers, followed by @Dddent2 and @The_BDJ.Discussion Ground breaking issues such as genomic medicine, stem cells, tissue engineering, nanotechnology, and artificial intelligence were not seen among the highly tweeted dental articles. In the 'Twittersphere', some independent scientists are more active than well-known dental organisations and journals. The journals are strongly recommended to be proactive in Twittersphere, to set up their own Twitter profile, and to promote their visibility and social impact by immediately tweeting the articles. Researchers should be alert to the overuse of Twitter in scholarly communications. The Kardashian index will be a useful tool to measure the over/under activity of a researcher on Twitter.

Use of a Coordinated Social Media Strategy to Improve Dissemination of Research and Collect Solutions Related to Workforce Gender Equity

Background: To increase awareness, search for solutions, and drive change, disparity-related research needs to be strategically disseminated. This study aimed to quantify whether a social media strategy could: (1) amplify dissemination of gender equity-related articles and (2) collect proposed solutions to gender equity issues. Methods: In April 2018, eight published journal articles covering separate gender equity issues were presented in a 1-hour Twitter chat hosted by Physician's Weekly. Metrics data were collected before, during, and after the chat. During the chat, one question related to each article was tweeted at a time. Qualitative data were extracted from responses and evaluated for thematic content. Results: In the 16-hour period during and following the chat, we tallied 1500 tweets from 294 participants and 8.6 million impressions (potential views). The Altmetric Attention Score of each article increased (average, 126.5 points; range, 91-208 points). Within the respective journal, the Altmetric Rank of seven articles improved (range, 3 to ≥19), while the eighth maintained its #1 rank. The one article for which share and download data were available experienced a 729% increase in shares following prechat posts and another 113% bump after the chat, a 1667% increase overall (n = 45-795). Similarly, downloads, and presumably reads, increased 712% following prechat posts and another 47% bump after the chat, a 1093% increase overall (n = 394-4700). We tallied 181 potential solutions to the eight gender equity-related questions. Conclusion: Our results demonstrate that social media can be used strategically to increase the dissemination of research articles and collect solution-focused feedback.

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.

Reach of Messages in a Dental Twitter Network: Cohort Study Examining User Popularity, Communication Pattern, and Network Structure

Background

Increasing the reach of messages disseminated through Twitter promotes the success of Twitter-based health education campaigns.

Objective

This study aimed to identify factors associated with reach in a dental Twitter network (1) initially and (2) sustainably at individual and network levels.

Methods

We used instructors’ and students’ Twitter usernames from a Saudi dental school in 2016-2017 and applied Gephi (a social network analysis tool) and social media analytics to calculate user and network metrics. Content analysis was performed to identify users disseminating oral health information. The study outcomes were reach at baseline and sustainably over 1.5 years. The explanatory variables were indicators of popularity (number of followers, likes, tweets retweeted by others), communication pattern (number of tweets, retweets, replies, tweeting/ retweeting oral health information or not). Multiple logistic regression models were used to investigate associations.

Results

Among dental users, 31.8% had reach at baseline and 62.9% at the end of the study, reaching a total of 749,923 and dropping to 37,169 users at the end. At an individual level, reach was associated with the number of followers (baseline: odds ratio, OR=1.003, 95% CI=1.001-1.005 and sustainability: OR=1.002, 95% CI=1.0001-1.003), likes (baseline: OR=1.001, 95% CI=1.0001-1.002 and sustainability: OR=1.0031, 95% CI=1.0003-1.002), and replies (baseline: OR=1.02, 95% CI=1.005-1.04 and sustainability: OR=1.02, 95% CI=1.004-1.03). At the network level, users with the least followers, tweets, retweets, and replies had the greatest reach.

Conclusions

Reach was reduced by time. Factors increasing reach at the user level had different impact at the network level. More than one strategy is needed to maximize reach.

Social Medicine: Twitter in Healthcare

Social media enables the public sharing of information. With the recent emphasis on transparency and the open sharing of information between doctors and patients, the intersection of social media and healthcare is of particular interest. Twitter is currently the most popular form of social media used for healthcare communication; here, we examine the use of Twitter in medicine and specifically explore in what capacity using Twitter to share information on treatments and research has the potential to improve care. The sharing of information on Twitter can create a communicative and collaborative atmosphere for patients, physicians, and researchers and even improve quality of care. However, risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties in verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. Ultimately, the use of Twitter in healthcare can allow patients, healthcare professionals, and researchers to be more informed, but specific guidelines for appropriate use are necessary.

Ask an anatomist: Identifying global trends, topics and themes of academic anatomists using twitter

Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter^® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy-related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active "tweeters". Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web-based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270-281. © 2017 American Association of Anatomists.

Neurology and the Internet: a review

Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

Effectiveness of Online Collaborative Care for Treating Mood and Anxiety Disorders in Primary Care: A Randomized Clinical Trial

IMPORTANCE

Collaborative care for depression and anxiety is superior to usual care from primary care physicians for these conditions; however, challenges limit its provision in routine practice and at scale. Advances in technology may overcome these barriers but have yet to be tested.

OBJECTIVE

To examine the effectiveness of combining an internet support group (ISG) with an online computerized cognitive behavioral therapy (CCBT) provided via a collaborative care program for treating depression and anxiety vs CCBT alone and whether providing CCBT in this manner is more effective than usual care.

DESIGN, SETTING, AND PARTICIPANTS

In this 3-arm randomized clinical trial with blinded outcome assessments, primary care physicians from 26 primary care practices in Pittsburgh, Pennsylvania, referred 2884 patients aged 18 to 75 years in response to an electronic medical record prompt from August 2012 to September 2014. Overall, 704 patients (24.4%) met all eligibility criteria and were randomized to CCBT alone (n = 301), CCBT+ISG (n = 302), or usual care (n = 101). Intent-to-treat analyses were conducted November 2015 to January 2017.

INTERVENTIONS

Six months of guided access to an 8-session CCBT program provided by care managers who informed primary care physicians of their patients' progress and promoted patient engagement with our online programs.

MAIN OUTCOMES AND MEASURES

Mental health-related quality of life (12-Item Short-Form Health Survey Mental Health Composite Scale) and depression and anxiety symptoms (Patient-Reported Outcomes Measurement Information System) at 6-month follow-up, with treatment durability assessed 6 months later.

RESULTS

Of the 704 randomized patients, 562 patients (79.8%) were female, and the mean (SD) age was 42.7 (14.3) years. A total of 604 patients (85.8%) completed our primary 6-month outcome assessment. At 6-month assessment, 254 of 301 patients (84.4%) receiving CCBT alone started the program (mean [SD] sessions completed, 5.4 [2.8]), and 228 of 302 patients (75.5%) in the CCBT+ISG cohort logged into the ISG at least once, of whom 141 (61.8%) provided 1 or more comments or posts (mean, 10.5; median [range], 3 [1-306]). Patients receiving CCBT+ISG reported similar 6-month improvements in mental health-related quality of life, mood, and anxiety symptoms compared with patients receiving CCBT alone. However, compared with patients receiving usual care, patients in the CCBT alone cohort reported significant 6-month effect size improvements in mood (effect size, 0.31; 95% CI, 0.09-0.53) and anxiety (effect size, 0.26; 95% CI, 0.05-0.48) that persisted 6 months later, and completing more CCBT sessions produced greater effect size improvements in mental health-related quality of life and symptoms.

CONCLUSIONS AND RELEVANCE

While providing moderated access to an ISG provided no additional benefit over guided CCBT at improving mental health-related quality of life, mood, and anxiety symptoms, guided CCBT alone is more effective than usual care for these conditions.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT01482806.