Web-Based Forums for People Experiencing Substance Use or Gambling Disorders: Scoping Review

BACKGROUND

For people experiencing substance use or gambling disorders, web-based peer-supported forums are a space where they can share their experiences, gather around a collective goal, and find mutual support. Web-based peer support can help to overcome barriers to attending face-to-face meetings by enabling people experiencing addiction to seek support beyond their physical location and with the benefit of anonymity if desired. Understanding who participates in web-based peer-supported forums (and how), and the principles underpinning forums, can also assist those interested in designing or implementing similar platforms.

OBJECTIVE

This study aims to review the literature on how people experiencing substance use or gambling disorders, and their family, friends, and supporters, use and participate in web-based peer-supported forums. Specifically, we asked the following research questions: (1) What are the characteristics of people who use web-based peer-supported substance use or gambling-focused forums? (2) How do people participate in web-based peer-supported forums? (3) What are the key principles reportedly underpinning the web-based peer-supported forums? (4) What are the reported outcomes of web-based peer-supported forums?

METHODS

Inclusion criteria for our scoping review were peer-reviewed primary studies reporting on web-based addiction forums for adults and available in English. A primary search of 10 databases occurred in June 2021, with 2 subsequent citation searches of included studies in September 2022 and February 2024.

RESULTS

Of the 14 included studies, the majority of web-based peer-supported forums reported were aimed specifically for, or largely used by, people experiencing alcohol problems. Results from the 9 studies that did report demographic data suggest forum users were typically women, aged between 40 years and early 50 years. Participation in web-based peer-supported forums was reported quantitatively and qualitatively. The forums reportedly were underpinned by a range of key principles, mostly mutual help approaches and recovery identity formation. Only 3 included studies reported on outcomes for forum users.

CONCLUSIONS

Web-based peer-supported forums are used by people experiencing addiction in a number of ways, to share information and experiences, and give and receive support. Seeking web-based support offers an alternative approach to traditional face-to-face support options, and may reduce some barriers to engaging in peer support.

[Digital Applications in the Planning and Implementation of Structural Health Promotion and Prevention Settings: Results of a Scoping Review]

BACKGROUND AND OBJECTIVES

In health promotion and prevention, digital applications, especially for behavioral changes, are being increasingly researched and applied. The aim of this study was to investigate possible uses of digital applications in the context of structurally oriented interventions in these settings.

METHODS

This is a supplementary analysis of the results of a scoping review. Eight scientific databases were searched for digital structural primary prevention and health promotion in settings from 2010-2020.

RESULTS

A total of 34 articles were included. Digital applications were found to be used only marginally for structural change in health promoting settings. They served as tools for project management, networking, problem identification, consensus building or participation. Participatory methods and projects were used, as well as tools such as labeling, placement, prompting, incentives, nudges, and political strategies.

CONCLUSIONS

More evidence is needed on how digital applications can be used to change structures in health promoting settings. Public health or sociological methods and theories can play a supporting role. The interdisciplinary and participatory development and implementation of health promoting technologies is of high relevance.

Digital Health Promotion and Prevention in Settings: Scoping Review

BACKGROUND

Digital technologies are increasingly integrating into people's daily living environments such as schools, sport clubs, and health care facilities. These settings play a crucial role for health promotion and prevention because they affect the health of their members, as the World Health Organization has declared. Implementing digital health promotion and prevention in settings offers the opportunity to reach specific target groups, lower the costs of implementation, and improve the health of the population. Currently, there is a lack of scientific evidence that reviews the research on digital health promotion and prevention in settings.

OBJECTIVE

This scoping review aims to provide an overview of research targeting digital health promotion and primary prevention in settings. It assesses the range of scientific literature regarding outcomes such as applied technology, targeted setting, and area of health promotion or prevention, as well as identifies research gaps.

METHODS

The scoping review was conducted following the Levac, Colquhoun, and O'Brien framework. We searched scientific databases and gray literature for articles on digital setting-based health promotion and prevention published from 2010 to January 2020. We included empirical and nonempirical publications in English or German and excluded secondary or tertiary prevention and health promotion at the workplace.

RESULTS

From 8888 records, the search resulted in 200 (2.25%) included publications. We identified a huge diversity of literature regarding digital setting-based health promotion and prevention. The variety of technology types extends from computer- and web-based programs to mobile devices (eg, smartphone apps) and telemonitoring devices (sensors). We found analog, digital, and blended settings in which digital health promotion and prevention takes place. The most frequent analog settings were schools (39/200, 19.5%) and neighborhoods or communities (24/200, 12%). Social media apps were also included because in some studies they were defined as a (digital) setting. They accounted for 31.5% (63/200) of the identified settings. The most commonly focused areas of health promotion and prevention were physical activity (81/200, 40.5%), nutrition (45/200, 22.5%), and sexual health (34/200, 17%). Most of the interventions combined several health promotion or prevention methods, including environmental change; providing information, social support, training, or incentives; and monitoring. Finally, we found that the articles mostly reported on behavioral rather than structural health promotion and prevention.

CONCLUSIONS

The research field of digital health promotion and prevention in settings is heterogeneous. At the same time, we identified research gaps regarding the absence of valid definitions of relevant terms (eg, digital settings) and the lack of literature on structural health promotion and prevention in settings. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies to achieve health promotion and prevention in settings.

Social Media as a Research Tool (SMaaRT) for Risky Behavior Analytics: Methodological Review

BACKGROUND

Modifiable risky health behaviors, such as tobacco use, excessive alcohol use, being overweight, lack of physical activity, and unhealthy eating habits, are some of the major factors for developing chronic health conditions. Social media platforms have become indispensable means of communication in the digital era. They provide an opportunity for individuals to express themselves, as well as share their health-related concerns with peers and health care providers, with respect to risky behaviors. Such peer interactions can be utilized as valuable data sources to better understand inter-and intrapersonal psychosocial mediators and the mechanisms of social influence that drive behavior change.

OBJECTIVE

The objective of this review is to summarize computational and quantitative techniques facilitating the analysis of data generated through peer interactions pertaining to risky health behaviors on social media platforms.

METHODS

We performed a systematic review of the literature in September 2020 by searching three databases-PubMed, Web of Science, and Scopus-using relevant keywords, such as "social media," "online health communities," "machine learning," "data mining," etc. The reporting of the studies was directed by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two reviewers independently assessed the eligibility of studies based on the inclusion and exclusion criteria. We extracted the required information from the selected studies.

RESULTS

The initial search returned a total of 1554 studies, and after careful analysis of titles, abstracts, and full texts, a total of 64 studies were included in this review. We extracted the following key characteristics from all of the studies: social media platform used for conducting the study, risky health behavior studied, the number of posts analyzed, study focus, key methodological functions and tools used for data analysis, evaluation metrics used, and summary of the key findings. The most commonly used social media platform was Twitter, followed by Facebook, QuitNet, and Reddit. The most commonly studied risky health behavior was nicotine use, followed by drug or substance abuse and alcohol use. Various supervised and unsupervised machine learning approaches were used for analyzing textual data generated from online peer interactions. Few studies utilized deep learning methods for analyzing textual data as well as image or video data. Social network analysis was also performed, as reported in some studies.

CONCLUSIONS

Our review consolidates the methodological underpinnings for analyzing risky health behaviors and has enhanced our understanding of how social media can be leveraged for nuanced behavioral modeling and representation. The knowledge gained from our review can serve as a foundational component for the development of persuasive health communication and effective behavior modification technologies aimed at the individual and population levels.

Engagement in a Novel Internet Intervention for Alcohol Reduction: A Qualitative Study of User Motivations and Experiences

Internet interventions are effective in reducing alcohol consumption, but little is known regarding their acceptability. We aimed to inform recruitment and retention strategies by exploring users' motivations and experiences in using a novel, Internet intervention, the Hello Sunday Morning (HSM) program. We conducted one-to-one, telephone-enabled qualitative interviews with 24 adult users of HSM (50 percent female; M_age = 42.42 years), purposively selected to ensure diversity in demographics and drinking levels. Data were analyzed using thematic analysis. Two themes, each with two subthemes were identified: (1a) pathway to HSM: HSM attracted participants seeking help for alcohol-related problems, and those not yet seeking help; (1b) format and framing: the positive, nonthreatening framing and anonymous, convenient format enabled participants to join out of interest, curiosity, or desire for a challenge; (2a) support and normalization: participants gained social support from other users, and their problems with alcohol and desire to seek help were normalized; (2b) goal setting and self-monitoring: setting goals and monitoring progress provided participants with motivation and self-accountability. We conclude that evidence-based behavior change techniques, including social support, normative strategies, goal setting, and self-monitoring, were appealing to users. These aspects could be incorporated into other programs to recruit participants who might otherwise avoid or delay seeking help.

The Promotion of Policy Changes Restricting Access to Codeine Medicines on Twitter: What do National Pain Organizations Say?

Codeine is one of the most common opioid medicines for treating pain. Australia introduced policy changes in February 2018 to up-schedule codeine to prescription-only medicine due to concerns of adverse effects, opioid dependency, and overdose-related mortality. This study investigated the frequency and content of messages promoted on Twitter by 4 Australian peak pain organizations, pre- and postpolicy implementation. A time series analysis examined frequency of Twitter posts over a 48-week period. Text analysis via Leximancer examined message content. Results showed that promotion and education of the pending policy change dominated the Twitter feed prior to up-scheduling. However, immediately following policy change, there was a shift in content towards promoting conferences and research, and a significant decrease in the frequency of codeine-related posts, compared to opioid-related non-codeine posts. The findings suggest that pain organizations can provide timely and educational policy dissemination in the online environment. They have implications for individuals with chronic pain who use the Internet for health information and the degree to which they can trust these sources, as well as health professionals. Further research is required to determine if public health campaigns can be targeted to prevent opioid-related harm and improve pain care via this increasingly used medium. PERSPECTIVE: This study presents a first look at what information is being communicated by influential pain organizations that have an online Twitter presence and how messages were delivered during a major policy change restricting access to codeine medicines. Insights could drive targeted future online health campaigns for improved pain management.

Citizen Health Science: Foundations of a New Data Science Arena

Citizen scientists with health interests have rapidly increased efforts to conduct their own health studies on themselves and in their communities, giving rise to a new transdisciplinary field of citizen health science. This science leverages long-standing traditions of single case or N-of-1 studies in psychology and also finds influential roots in the history of self-experimentation in health and medicine. These studies frequently incorporate new digital tools such as smartphone tracking and many other mobile health or "mHealth" devices. Citizen health scientists also tend to operate in social networks of people working to maintain or improve their health, increasing the complexity and richness of opportunities tied to this new platform. Population data scientists are well-positioned to seek new ways to derive scientific inferences from data generated in citizen health science projects. This paper provides an overview of citizen health science for population data scientists, including basic definitions, historical foundations, current challenges and opportunities, and future directions.

Incarnation and the dynamics of medical promises: DHEA as a fountain of youth hormone

For more than a decade, the sociology of hope and expectations has gained growing influence in the social studies of health, medicine, and healthcare. This literature has stressed the role of representations of the future-through images, metaphors, theories, or visions-in the medical sector and analyzed the translation of these discursive contents into social practices and organizations. This article builds on these results and intends to explore a dimension that has received less attention: the incarnation of medical promises. Looking at the evolving case of a particular molecule, dehydroepiandrosterone (DHEA)-which has been promoted from the mid-1990s onwards as a "fountain of youth" pill-, we emphasize that testimonies by and portrayals of those who are undergoing a treatment with uncertain risks and benefits, and representations of their bodies in the media, can play a key role in the performativity of a medical promise. We analyze this incarnation as a specific "form of veridiction" and stress its normative dimension. This leads us to underline how evidence-based medicine and experiential knowledge-which are often analyzed as two opposite sources of information-can intricate and give rise to the same incarnation dynamics.

Hello Sunday Morning: Strategies used to support temporary alcohol abstinence through participation in an online health promotion program

ISSUE ADDRESSED

Hello Sunday Morning (HSM) is an online program that encourages people to commit to a period of non-drinking and blog about their experiences. Among a sample of Victorian HSM users, we aimed to explore the barriers faced and the strategies adopted to maximise potential for achieving temporary abstinence.

METHODS

A content analysis of blog data from 154 HSM users (a total of 2844 blog posts) was undertaken by three researchers. Participants were predominantly women aged 30-50 years.

RESULTS

The most common barriers to achieving temporary alcohol abstinence reported by participants were stress and tiredness, pervasiveness of drinking in social life, negative effects from not drinking and negative reactions from others. The strategies most commonly implemented included drawing on HSM and other non-drinking networks, self-talk, engaging in non-alcohol-related activities and substituting alcohol with other drinks.

CONCLUSIONS

Although significant individual and systemic barriers to abstaining from alcohol were identified by HSM users, multiple strategies were identified and effectively utilised to overcome these barriers. SO WHAT?: We suggest that the virtual support from an online community with a shared interest in reducing their alcohol use appears to be a useful health promotion strategy for temporarily reducing consumption, particularly for women.