Human Papillomavirus Vaccine Messaging on TikTok: Social Media Content Analysis

HPV vaccine misinformation on social media: A multi-method qualitative analysis of comments across three platforms

Objective The purpose of this study was to characterize similarities and differences in HPV vaccine misinformation narratives present in the comment sections of top-performing initial creator posts across three social media platforms. Methods A qualitative multi-method design was used to analyze comments collected from social media posts. A sample of 2996 comments were used for thematic analysis (identifying similar themes) and content analysis (identifying differences in comment type, opinion, and misinformation status). Results Misinformation was pervasive in comment sections. Cross-cutting misinformation themes included adverse reactions, unnecessary vaccine, conspiracy theories, and mistrust of authority. The proportion of comments related to these themes varied by platform. Initial creator posts crafted to be perceived as educational or with an anti-vaccine opinion had a higher proportion of misinformation in the comment sections. Facebook had the highest proportion of misinformation comments. Conclusion Differences in the proportion of cross-cutting themes in the comment sections across platforms suggests the need for targeted communication strategies to counter misinformation narratives and support vaccine uptake. Innovation This study is innovative due to its characterization of misinformation themes across three social media platforms using multiple qualitative methods to assess similarities and differences and focusing on conversations occurring within the comment sections.

Facebook's shared articles on HPV vaccination: analysis of persuasive strategies

BACKGROUND

The current study analyzed articles shared on Facebook between 2019 and 2021 that discuss the HPV vaccine. Results address a gap in knowledge about the persuasive strategies used in HPV vaccine discourse on Facebook.

METHODS

Using Buzzsumo.com, we collected 138 articles, shared on Facebook between 2019 and 2021, with the highest "engagement scores," or total number of reactions, comments, and shares. Using a content analysis methodology, three independent coders were trained in using the study codebook, achieved acceptable inter-rater reliability (Krippendorf's alpha = 0.811), and coded each article in Atlas.ti.

RESULTS

Seventy-two articles had a positive valence toward the HPV vaccine, 48 had a negative valence, and 18 were mixed-valence or neutral. Pro-vaccine articles presented a variety of evidence types in support of benefits of HPV vaccination. Pro-vaccine articles primarily originated from national and local news sources. Anti-vaccine articles combined presentation of evidence with persuasive arguments and strategies, such as mistrust of institutions, fear appeals, ideological appeals, presenting a high number of arguments or detail, and minimizing the severity of HPV. Three sources were responsible for producing 62.5% of all anti-vaccine articles in the dataset. Mixed-valence or neutral articles mixed cancer prevention discourse with ideological appeals about protecting parental rights, and were mostly produced by local news outlets.

CONCLUSION

The results of this study can help health communicators anticipate the types of discourses that vaccine-hesitant parents may have encountered online. Implications and suggestions for practice are discussed.

Mediterranean Diet Information on TikTok and Implications for Digital Health Promotion Research: Social Media Content Analysis

BACKGROUND

The Mediterranean diet has been linked to reduced risk for several cardiometabolic diseases. The lack of a clear definition of the Mediterranean diet in the scientific literature and the documented proliferation of nutrition misinformation on the internet suggest the potential for confusion among consumers seeking web-based Mediterranean diet information.

OBJECTIVE

We conducted a social media content analysis of information about the Mediterranean diet on the influential social media platform, TikTok, to examine public discourse about the diet and identify potential areas of misinformation. We then analyzed these findings in the context of health promotion to identify potential challenges and opportunities for the use of TikTok in promoting the Mediterranean diet for healthy living.

METHODS

The first-appearing 202 TikTok posts that resulted from a search of the hashtag #mediterraneandiet were downloaded and qualitatively examined. Post features and characteristics, poster information, and engagement metrics were extracted and synthesized across posts. Posts were categorized as those created by health professionals and those created by nonhealth professionals based on poster-reported credentials. In addition to descriptive statistics of the entire sample, we compared posts created by professionals and nonprofessionals for content using chi-square tests.

RESULTS

TikTok posts varied in content, but posts that were developed by health professionals versus nonprofessionals were more likely to offer a definition of the Mediterranean diet (16/106, 15.1% vs 2/96, 2.1%; P=.001), use scientific citations to support claims (26/106, 24.5% vs 0/96, 0%; P<.001), and discuss specific nutrients (33/106, 31.1% vs 6/96, 6.3%; P<.001) and diseases related to the diet (27/106, 25.5% vs 5/96, 5.2%; P<.001) compared to posts created by nonhealth professionals.

CONCLUSIONS

Social media holds promise as a venue to promote the Mediterranean diet, but the variability in information found in this study highlights the need to create clear definitions about the diet and its components when developing Mediterranean diet interventions that use new media structures.

Using Social Listening for Digital Public Health Surveillance of Human Papillomavirus Vaccine Misinformation Online: Exploratory Study

Despite challenges related to the data quality, representativeness, and accuracy of artificial intelligence-driven tools, commercially available social listening platforms have many of the attributes needed to be used for digital public health surveillance of human papillomavirus vaccination misinformation in the online ecosystem.

Australian youth perspectives on the role of social media in climate action

OBJECTIVE

The climate crisis poses a significant public health threat to current and future generations. Limited research has examined young people's perspectives about the role of social media for climate awareness, action, and policy change.

METHODS

Qualitatively led online survey of n=500 young Australians (aged 15-24). Questions focused on the effectiveness of social media platforms in communicating the need for climate action, with TikTok videos used to prompt about appeal strategies and campaigns. Data were analysed using a reflexive approach to thematic analysis.

RESULTS

Participants perceived that social media platforms were a powerful and inclusive communication mechanism for climate action. Social media had the ability to reach diverse audiences and connect young people globally. Limitations included influencing key decision makers and risks associated with misinformation and disinformation. Participants supported messages that highlighted the urgent need for action, trusted celebrity and youth voices, and practical information to engage in action.

CONCLUSIONS

Social media presents a powerful opportunity for engaging young people in discussions and decisions made about the climate crisis.

IMPLICATIONS FOR PUBLIC HEALTH

The public health community should be guided by young people in developing a range of social media mechanisms to empower them to have a seat at the table in public health responses to climate.

Popular contraception videos on TikTok: An assessment of content topics

OBJECTIVES

This study aimed to explore the contraception content topics on the highly popular social media platform TikTok to understand this influential information source patients may bring into birth control counseling visits.

STUDY DESIGN

Utilizing a snapshot method, we collected the 100 most popular TikTok English-language videos for each of the eight contraception-specific search terms. We abstracted video content topics addressed and creator attributes. Two independent abstractors coded each video with high agreement, with a third coder adjudicating discrepancies.

RESULTS

The final data set included 700 unique videos, with a total of 1.18 billion views, 131 million likes, 1.5 million comments, and 4.1 million shares. In these videos, the most common topics addressed were patient experience (n = 365, 52.1%) and logistics of use (n = 351, 50.1%). Health care professionals created only 19.3% of videos (n = 135), but these videos accounted for a larger portion of the total video views (41.3%). Health care professionals largely made educational videos (92.6%) compared to 22.5% of videos coded as educational videos when made by perceived non-health care professionals. A small number of prolific video creators developed the majority of videos made by health care professionals, with 91 (67.4%) made by six TikTok creators.

CONCLUSIONS

TikTok contains highly accessible contraception content, which garners high viewership, especially when created by health care providers. Clinicians should be aware of TikTok's potential to influence patients prior to contraceptive counseling visits and recognize this platform as a public health instrument to disseminate contraceptive information to a key demographic.

IMPLICATIONS

Few previous studies have examined the presence and popularity of contraception content topics on TikTok; little is known about the health content on this highly popular platform. Providers should be aware of the contraceptive topics on TikTok for understanding both patient perceptions and the potential for health education through this media.

Exploring the vaccine conversation on TikTok in Italy: beyond classic vaccine stances

TikTok, a social media platform for creating and sharing short videos, has seen a surge in popularity during the COVID-19 pandemic. To analyse the Italian vaccine conversation on TikTok, we downloaded a sample of videos with a high play count (Top Videos), identified through an unofficial Application Programming Interface (consistent with TikTok's Terms of Service), and collected public videos from vaccine sceptic users through snowball sampling (Vaccine Sceptics' videos). The videos were analysed using qualitative and quantitative methods, in terms of vaccine stance, tone of voice, topic, conformity with TikTok style, and other characteristics. The final datasets consisted of 754 Top Videos (by 510 single users) plus 180 Vaccine Sceptics' videos (by 29 single users), posted between January 2020 and March 2021. In 40.5% of the Top Videos the stance was promotional, 33.9% were indefinite-ironic, 11.3% were neutral, 9.7% were discouraging, and 3.1% were ambiguous (i.e. expressing an ambivalent stance towards vaccines); 43% of promotional videos were from healthcare professionals. More than 95% of the Vaccine Sceptic videos were discouraging. Multiple correspondence analysis showed that, compared to other stances, promotional videos were more frequently created by healthcare professionals and by females, and their most frequent topic was herd immunity. Discouraging videos were associated with a polemical tone of voice and their topics were conspiracy and freedom of choice. Our analysis shows that Italian vaccine-sceptic users on TikTok are limited in number and vocality, and the large proportion of videos with an indefinite-ironic stance might imply that the incidence of affective polarisation could be lower on TikTok, compared to other social media, in the Italian context. Safety is the most frequent concern of users, and we recorded an interesting presence of healthcare professionals among the creators. TikTok should be considered as a medium for vaccine communication and for vaccine promotion campaigns.

Using TikTok for public and youth mental health - A systematic review and content analysis

Globally, TikTok is now the fastest growing social media platform among children and young people; but it remains surprisingly under-researched in psychology and psychiatry. This is despite the fact that social media platforms have been subject to intense academic and societal scrutiny regarding their potentially adverse effects on youth mental health and wellbeing, notwithstanding the inconsistent findings across the literature. In this two part study, we conducted a systematic review concerning studies that have examined TikTok for any public health or mental health purpose; and a follow-up content analysis of TikTok within an Irish context. For study 1, a predetermined search strategy covering representative public and mental health terminology was applied to six databases - PSYCINFO, Google Scholar, PUBMED, Wiley, Journal of Medical Internet Research, ACM - within the period 2016 to 2021. Included studies were limited to English-speaking publications of any design where TikTok was the primary focus of the study. The quality appraisal tool by Dunne et al., (2018) was applied to all included studies. For study 2, we replicated our search strategy from study 1, and converted this terminology to TikTok hashtags to search within TikTok in combination with Irish-specific hashtags. As quantified by the app, the top two "most liked" videos were selected for inclusion across the following three targeted groups: official public health accounts; registered Irish charities; and personal TikTok creators. A full descriptive analysis was applied in both studies. Study 1 found 24 studies that covered a range of public and mental health issues: COVID-19 (n = 10), dermatology (n = 7), eating disorders (n = 1), cancer (n = 1), tics (n = 1), radiology (n = 1), sexual health (n = 1), DNA (n = 1), and public health promotion (n = 1). Studies were predominately from the USA, applied a content analysis design, and were of acceptable quality overall. In study 2, 29 Irish TikTok accounts were analysed, including the accounts of public health authorities (n = 2), charity or non-profit (n = 5), and personal TikTok creators (n = 22). The overall engagement data from these accounts represented a significant outreach to younger populations: total likes n = 2,588,181; total comments n = 13,775; and total shares n = 21,254. TikTok has been utilised for a range of public health purposes, but remains poorly engaged by institutional accounts. The various mechanisms for connecting with younger audiences presents a unique opportunity for youth mental health practitioners to consider, yet there were distinct differences in how TikTok accounts used platform features to interact. Overall, there is an absence of high quality mixed methodological evaluations of TikTok content for public and mental health, despite it being the most used platform for children and young people.