The effect of social media interventions on physical activity and dietary behaviours in young people and adults: a systematic review

Examining the Association between Social Media Use and Dietary Habits among College Students in Riyadh, Saudi Arabia

Food culture plays a vital role in societal dynamics, with various factors influencing dietary choices beyond hunger. Among these factors are external eating, triggered by environmental cues, and emotional eating, which are common stress-coping mechanisms among college students. Social media has a significant impact on nutrition by providing access to food-related content, which can lead to restrictive diets or unhealthy eating habits. High social media engagement is associated with an increased risk of chronic diet-related conditions such as metabolic syndrome. This study investigated the association between social media use and dietary habits among college students in Riyadh, Saudi Arabia. The cross-sectional study surveyed 401 participants online. The findings revealed that 74.6% of participants were women, with a mean age of 20.75 years. A significant portion (51.9%) reported spending over four hours daily on social media, with TikTok, Instagram, and YouTube being the primary sources of nutritional information. Statistical analysis indicated significant differences in dietary scores related to having children, medical conditions, and social media usage time. This study highlights the negative impact of extensive social media use on dietary habits and suggests the need for targeted public health interventions. Recommendations include promoting reliable nutrition-related content on social media, offering affordable healthy food options on campuses, and conducting further research to establish causality between social media use and dietary habits.

Participation in physical activity and sport in adolescent girls from Middle Eastern backgrounds

OBJECTIVES

This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia.

DESIGN

A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis.

RESULTS

Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology.

CONCLUSION

The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds.

Latent classes of adolescent health behaviour, social covariates and mental wellbeing: a longitudinal birth cohort study

BACKGROUND

Adolescent mental wellbeing has been declining in the United Kingdom for over a decade. Expansion of services to support the mental wellbeing of young people is a public health priority and a core component of the National Health Service's Long-Term Plan. In this paper, we leverage secondary analysis of a very large longitudinal dataset (#BeeWell) to generate insights regarding different patterns of health behaviour, their covariates, and consequences for mental wellbeing one year later.

METHODS

A Latent Class Analysis was conducted using data on physical activity, sleep, and eating habits collected in 2021 from 18,478 Year 8 pupils from Greater Manchester (United Kingdom) to (1) identify distinct latent classes of adolescent health behaviour; (2) establish factors likely to be associated with latent class membership; and (3) determine whether latent class membership contributes to variance in self-reported mental wellbeing one year later.

RESULTS

A three-class solution was identified as an excellent fit to the data, discriminating between: the Wellness Weary (n = 2,717; 15%); the Balanced Bunch (n = 7,377; 40%); and the Green and Dream Team (n = 8,384; 45%). Several factors significantly influenced class membership. Most notably, socio-economic disadvantage and social media use were linked with less favourable health behaviour patterns, whilst cisgender heterosexual girls were likely to endorse healthier patterns. After adjusting for covariates, the Green and Dream Team reported significantly greater mental wellbeing than the Balanced Bunch one year later. However, there was no difference between the Balanced Bunch and the Wellness Weary, signalling that health behaviours may support mental wellbeing, but only among the healthiest young people.

CONCLUSIONS

Beyond advancements in fundamental understanding, our findings yield significant translation opportunities through their use and application in health, education, and allied professional settings designed to support young people.

Social Networks as a Tool for Evidence-Based Health Education: Umbrella Review

BACKGROUND

The number of people who access social networking sites continues to increase at an exponential rate. The use of technology is an essential skill for nursing professionals and its development represents a challenge in improving health education, promotion and care. The objective of this systematic review is to analyse the use of social networking sites by healthcare professionals as an intervention tool for evidence-based public health education.

METHODS

The protocol of this umbrella review was registered in the International Prospective Register of Systematic Reviews (CRD42023407249). Searches were carried out in MEDLINE (PubMed), Web of Science, CINAHL, PsycINFO (EBSCOhost), and Cochrane Library of Systematic Reviews, in February 2023. A narrative synthesis of the results was conducted.

RESULTS

1896 articles were found, of which 15 reviews fulfilled the inclusion criteria. Social networks broadened the profession; they were YouTube, X (formerly Twitter), Facebook, and Instagram. The target population was mainly young professionals, and they came across different topic areas that addressed health education.

CONCLUSIONS

It is important to have information backed by scientific evidence to make health decisions. Health professionals active on social networking sites have a unique opportunity to educate the public about health by sharing scientific evidence in an accessible and clear way, which helps to combat misinformation.

Best Practices for Designing and Testing Behavioral and Health Communication Interventions for Delivery in Private Facebook Groups: Tutorial

Facebook, the most popular social media platform in the United States, is used by 239 million US adults, which represents 71% of the population. Not only do most US adults use Facebook but they also spend an average of 40 minutes per day on the platform. Due to Facebook's reach and ease of use, it is increasingly being used as a modality for delivering behavioral and health communication interventions. Typically, a Facebook-delivered intervention involves creating a private group to deliver intervention content for participants to engage with asynchronously. In many interventions, a counselor is present to facilitate discussions and provide feedback and support. Studies of Facebook-delivered interventions have been conducted on a variety of topics, and they vary widely in terms of the intervention content used in the group, use of human counselors, group size, engagement, and other characteristics. In addition, results vary widely and may depend on how well the intervention was executed and the degree to which it elicited engagement among participants. Best practices for designing and delivering behavioral intervention content for asynchronous delivery in Facebook groups are lacking, as are best practices for engaging participants via this modality. In this tutorial, we propose best practices for the use of private Facebook groups for delivery and testing the efficacy of behavioral or health communication interventions, including converting traditional intervention content into Facebook posts; creating protocols for onboarding, counseling, engagement, and data management; designing and branding intervention content; and using engagement data to optimize engagement and outcomes.

Exploring barriers to physical activity participation among female nursing students adhering to specific social-cultural norms in Indonesia: A qualitative study

Background

The prevalence of insufficient physical activity is common among nursing students and impacts their academic performance. Research on obstacles to physical activity (PA) among religious women, notably Muslims, is limited.

Objectives

This study aimed to explore barriers to PA among Indonesian Muslim female nursing students and gather suggestions for overcoming those barriers.

Methods

This study used a qualitative descriptive design. Two focus groups were conducted with 12 Muslim female nursing students in Makassar, Indonesia. Interviews were audio-recorded and transcribed verbatim. The data were collected from May and July 2019. Inductive thematic analysis was used to identify core themes and sub-themes.

Results

Thematic analysis identified barriers to PA across four main themes: intrapersonal, interpersonal, institutional, and social-cultural related to religious context. Each theme included two to three sub-themes, totaling nine categories of PA participation barriers. Intrapersonal barriers consisted of low motivation, emotional states, and a sedentary lifestyle. Interpersonal challenges included a lack of family or friend support and family obligations. Institutional barriers involved academic workload prioritization, school environment inaccessibility, and absence of athletic curriculum policy. Socio-cultural barriers posed by religious expectations included gender-related concerns and modest dressing. Drawing from their perspectives as Muslim female nursing students, study participants proposed six strategies to address these barriers. Proposed solutions include promoting PA through Apps, forming female team-up clubs, providing designated exercise spaces, and implementing mandatory athletic courses for nursing students at the institutional level. Additionally, offering female instructors and private exercise rooms could reduce the barriers from a socio-cultural perspective caused by religious expectations.

Conclusions

The study found that Muslim female nursing students with dual roles face increased barriers to PA participation, driven by intrapersonal and interpersonal levels, nursing learning load, and religious norms. Schools could build environments to meet the religious expectations within Indonesian society to promote PA for Muslim female nursing students. For example, the practical strategies include offering private rooms or female instructors when they physically exercise in school.

Influence of digital health literacy on online health-related behaviors influenced by internet advertising

BACKGROUND

The frequency of health-related information seeking on the internet and social media platforms has increased remarkably. Thus, the ability to understand and select accurate health-related information online, known as EHealth literacy, is crucial for the population. Therefore, this study aimed to evaluate how eHealth literacy influences the critical analysis of oral health-related information obtained from the Internet and its influence on oral health-related behaviors.  METHODS: A cross-sectional online study was conducted with 418 Brazilian adults who responded to the eHEALS questionnaire, with questions regarding the influence of online information on oral health decisions. Socioeconomic and demographic characteristics were also collected.

RESULTS

The mean eHEALS score was 27.85 (± 8.13), with a range spanning from 8 to 40 points. Participants with higher eHEALS scores reported using social media platforms to seek for dentists and to acque information about symptoms, diagnoses, and treatments. Furthermore, this group tended not to disregard professional health recommendations based on Internet information and abstained from utilizing products promoted by digital influencers. In multivariate models, increased eHEALS scores were associated with reduced consumption of products endorsed by digital influencers.

CONCLUSIONS

The findings from this study suggest that individuals with higher scores on the eHealth literacy questionnaire often conduct research on their health status and seek for health care providers on the Internet. Moreover, these individuals were less likely to be influenced by digital influencers.

Associations of Contemporary Screen Time Modalities With Early Adolescent Nutrition

OBJECTIVE

To determine the associations between screen time across several contemporary screen modalities (eg, television, video games, text, video chat, social media) and adherence to the Mediterranean-DASH (dietary approaches to stop hypertension) intervention for neurodegenerative delay (MIND) diet in early adolescents.

METHODS

We analyzed data from the Adolescent Brain Cognitive Development study of 9 to 12-year-old adolescents in the United States. Multiple linear regression analyses examined the relationship between self-reported screen time measures at baseline (year 0) and the 1-year follow-up (year 1) and caregiver-reported nutrition assessments at year 1, providing a prospective and cross-sectional analysis. Cross-sectional marginal predicted probabilities were calculated.

RESULTS

In a sample of 8267 adolescents (49.0% female, 56.9% white), mean age 10 years, total screen time increased from 3.80 h/d at year 0 to 4.61 h/d at year 1. Change in total screen time from year 0 and year 1 was associated with lower nutrition scores at year 1.

PROSPECTIVE

Screen time spent on television, video games, and videos at year 0 was associated with lower nutrition scores at year 1. Cross-sectional: Screen time spent on television, video games, videos, texting, and social media at year 1 was associated with lower MIND diet scores at year 1.

CONCLUSIONS

Both traditional (television) and several contemporary modalities of screen time are associated, prospectively and cross-sectionally, with lower overall diet quality, measured by the MIND diet nutrition score, in early adolescents. Future studies should further explore the effect of rising digital platforms and media on overall adolescent nutrition.

Type 2 Diabetes Mellitus and Cardiometabolic Prospects: A Rapid Narrative Review

Cardiometabolic syndrome (CMS), type 2 diabetes mellitus (T2DM), and cardiovascular diseases are among the major altruists to the international liability of disease. The lifestyle and dietary changes attributable to economic growth have resulted in an epidemiological transition towards non-communicable diseases (NCDs) as the leading causes of death. Low- and middle-income countries (LMICs) bear a more substantial disease burden due to limited healthcare sector capacities to address the rapidly growing number of chronic disease patients. The purpose of this narrative review paper was to explore the interrelationships between CMS, T2DM, and cardiovascular impairments in the context of NCDs, as well as major preventative and control interventions. The role of insulin resistance, hyperglycemia, and dyslipidemia in the pathogenesis of T2DM and the development of severe cardiovascular impairments was highlighted. This paper elaborated on the pivotal role of lifestyle modifications, such as healthy diets and physical activity, as cornerstones of addressing the epidemics of metabolic diseases. Foods high in calories, refined sugar, red meat, and processed and ready-to-eat meals were associated with an amplified risk of CMS and T2DM. In contrast, diets based on fruits, legumes, vegetables, and whole grain, home-cooked foods demonstrated protective effects against metabolic diseases. Additionally, the role of a psychological and behavioral approach in addressing metabolic diseases was highlighted, especially regarding its impact on patient empowerment and the patient-centered approach to preventative and therapeutic interventions.

Social marketing targeting healthy eating and physical activity in young adult university students: A scoping review

Adult obesity has remained a key health concern globally. Theory-based social marketing interventions are considered effective for improving dietary and physical activity (PA) behaviours. However, their application in universities is not yet established. This review aimed to identify social marketing strategies targeting healthy eating and/or PA behaviours of young adult university students and outline the intervention effectiveness. Literature search, screening, and data extraction followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. PubMed/Medline and Scopus databases were searched for intervention and exploratory studies published between January 1, 2000, and September 20, 2023. Twelve articles were selected based on the eligibility criteria. Although different in study design, all studies reported improved healthy eating-related outcomes, while three showed improved PA-related outcomes. One study incorporated all six of the social marketing benchmarks, but the majority identified two. Most studies focused on behavioural objective, formative research, and marketing mix in their intervention design. Four studies incorporated behaviour change theories in development of the social marketing campaigns. Social marketing using social media could be a significant approach for improving healthy eating and PA in young adult university students when behavioural change theories and all social marketing benchmarks are adopted. More generalizable longer-term investigation into the effectiveness of this approach in university young adults is needed to tackle adult obesity related health issues.

Promoting a healthy lifestyle: exploring the role of social media and fitness applications in the context of social media addiction risk

The popularity of social networks turns them into a legal method for promoting a healthy lifestyle, which benefits not only people but also different countries' governments. This research paper aimed to examine the Keep fitness app integrated into WeChat, Weibo and QQ as regards long-term improvements in health-related behaviors (physical activity, nutrition, health responsibility, spiritual growth, interpersonal relationships and stress management) and assess the associated risk of increased social media addiction. Students from Lishui University in China (N = 300) participated in this study, and they were formed into control and experimental groups. The Healthy Lifestyle Behavior Scale and Social Media Disorder Scale were used as psychometric instruments. The Keep app was found to improve respondents' scores on the parameters of physical activity, nutrition and health responsibility (P = 0.00). However, the level of dependence on social media did not change in either the control or the experimental group during the year of research (P ≥ 0.05). It is concluded that fitness apps can be an effective tool to promote healthy lifestyles among young people in China and other countries. The feasibility of government investment in fitness apps to promote healthy lifestyles is substantiated.

Social Media for Nutrition Education-A Randomized Controlled Trial to Promote Fruit and Vegetable Intake in a University Setting: "The University of Valladolid Community Eats Healthy" Study

Social media- and internet-based interventions are nowadays widely used tools in health interventions. Although evidence of their effectiveness is still low, their applications could be very promising due to their affordability and wide reach. The current paper aims to evaluate the effectiveness of an intervention program, "The University of Valladolid Community Eats Healthy" (UVEH), to increase fruit and vegetable (FV) intake in adults from the University of Valladolid (U. Valladolid) employing three online methodologies. A sample of 211 volunteers was randomly assigned into four groups: virtual campus (VC), Facebook (FB), Instagram (IG), and control. An intervention based on the Theory of Planned Behavior was implemented for seven weeks. Data were collected at the beginning (T0) and the end of the program (T1). The Predimed questionnaire was employed to assess FV intake. Vegetable intake was statistically significantly higher in the VC group (17.4% pre vs. 72.7% post). In the rest of the groups, there was also an increase in intake. Fruit consumption increased slightly only in the VC group (23.9% pre vs. 45.5% post). Participation decreased through the weeks: FB (week 2), IG (week 3), and VC (week 4). Retention was higher in the VC (48%) and control (60%) groups. Internet-based interventions employing interactive platforms such as virtual campus can be effective in enhancing participants' dietary habits in a clinically relevant manner.

The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol

INTRODUCTION

Adolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity to promote healthy eating habits. Social media has become a popular platform for promoting health interventions, particularly among young people. However, there is a lack of consensus on the effectiveness of social media interventions in this population. This mixed-method systematic review aims to synthesise the available evidence on the impact of social media interventions on healthy eating behaviours among young people, their qualitative views and user experiences, and the intervention characteristics, behaviour change theories and techniques used to promote healthy eating.

METHODS AND ANALYSIS

We will conduct a comprehensive search of seven electronic databases, including ASSIA, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science. The search strategy will use a combination of Medical Subject Headings terms and keywords covering three domains: social media, eating behaviours and young people. The search will be limited to peer-reviewed published papers in any language, published from 2000. Three independent reviewers will screen studies based on predetermined eligibility criteria. Data will be extracted and analysed using a convergent segregated mixed-method approach. We will use random-effect meta-analysis or Synthesis Without Meta-analysis for quantitative data and thematic synthesis for qualitative data. Finally, narrative synthesis using concurrent triangulation will be used to bring together the results of the mixed-method data analysis to provide a comprehensive and integrated understanding of the impact and other features of social media interventions. This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

ETHICS AND DISSEMINATION

Ethical approval is not required since this systematic review will not collect original data. The outcomes of this review will be shared through peer-reviewed publications and conference presentations and will contribute to the PhD thesis of the primary author.

PROSPERO REGISTRATION NUMBER

CRD42023414476.

A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism

This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.

Digging into digital buffets: A systematic review of eating-related social media content and its relationship with body image and eating behaviours

Recently, researchers have started investigating the influence of eating-focused social media content on viewers' body image and eating behaviour. The current systematic review collates the evidence for the relationship between exposure to eating-related social media content and people's body image, disordered eating, food consumption, and eating-related opinions. Following PRISMA guidelines, searches were conducted on five databases (i.e., Medline, PsycINFO, Web of Science, Scopus, and ProQuest), resulting in 38 eligible studies that examined the link between eating-related content and body image, eating behaviour and/or viewers' perceptions. Evidence showed positive relationships between exposure to certain material on social media (e.g., fast-food advertisements, clean eating, eating videos) and body image concerns, disordered eating, and consumption of, or a willingness to consume the foods seen on social media; however, studies that focused on 'healthy food' content showed no such link. Viewers expressed mixed feelings towards content such as nutrition information and mukbang videos which record hosts eating a large amount of food. Future research would benefit from a consistent measure of exposure to different eating-related content. There is also a need for more experimental research to examine the impact of watching different types of eating videos on body image, disordered eating, and food consumption.

#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial

BACKGROUND

Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas.

OBJECTIVE

This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah.

METHODS

We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign.

RESULTS

The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management.

CONCLUSIONS

Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/50392.

Associations between Health-Related Use of Social Media and Positive Lifestyle Behaviors: Findings from a Representative Sample of US Adult Smokers

Background: Cigarette smokers have elevated cardiovascular risk factors, which contributes significantly to mortality. Although social media is a potential avenue to deliver smoking interventions, its role in health promotion among smokers remains relatively unexplored.Objective: To examine the uptake and impact of health-related social media use in cigarette smokers.Methods: Using data from the 2017-2020 Health Information National Trends Survey, we evaluated differences in health-related social media use between smokers and nonsmokers. Multivariable logistic regression was performed to examine the association between social media use and positive health behaviors.Results: We included 1863 current smokers and 13,560 nonsmokers; Most participants were women (51.0%), White (64.6%), and 49.2% were aged ≥50 years. Smokers who used ≥1 social media site for health-related purposes in the past year were significantly more likely to meet the guideline recommendations for: (i) weekly physical activity (AOR 2.00, 95% CI 1.23-3.24), (ii) daily vegetable intake (AOR 2.48, 95% CI 1.10-5.59), and (iii) weekly strength training (AOR 1.80, 95% CI 1.10-2.94). However, the odds of reporting intentions to quit smoking (AOR 1.81, 95% CI 0.98-3.34) and attempts at smoking cessation (AOR 1.68, 95% CI 0.90-3.12) did not differ by health-related social media use.Conclusion: Smokers use social media for health-related purposes at comparable rates to nonsmokers. While our findings indicate that these platforms present a novel opportunity for health promotion among smokers, future research exploring the utility of social media in smoking cessation is crucial.

The status quo of short videos as a health information source of Helicobacter pylori: a cross-sectional study

Background

Health education about Helicobacter pylori (H. pylori) is one of the most effective methods to prevent H. pylori infection and standardize H. pylori eradication treatment. Short videos enable people to absorb and remember information more easily and are an important source of health education. This study aimed to assess the information quality of H. pylori-related videos on Chinese short video-sharing platforms.

Methods

A total of 242 H. pylori-related videos from three Chinese short video-sharing platforms with the most users, TikTok, Bilibili, and Kwai, were retrieved. The Global Quality Score (GQS) and the modified DISCERN tool were used to assess the quality and content of videos, respectively. Additionally, comparative analyzes of videos based on different sources and common H. pylori issues were also conducted.

Results

The median GQS score and DISCERN score was 2 for H. pylori-related videos analyzed in this study. Non-gastroenterologists posted the most H. pylori-related videos (136/242, 56.2%). Videos from gastroenterologists (51/242, 21.0%) had the highest GQS and DISCERN scores, with a median of 3. Few videos had content on family-based H. pylori infection control and management (5.8%), whether all H. pylori-positive patients need to undergo eradication treatment (27.7%), and the adverse effects of H. pylori eradication therapy (16.1%).

Conclusion

Generally, the content and quality of the information in H. pylori-related videos were unsatisfactory, and the quality of the video correlated with the source of the video. Videos from gastroenterologists provided more correct guidance with higher-quality information on the prevention and treatment of H. pylori infection.

#Wematter: Creating culturally tailored health promotion content for Black and Latina college women on Instagram

Objective

Although students at Minority-Serving Institutions (HBCUs, HSIs, TCUs, AAPISIs) have been found to make sound health choices as compared to their counterparts at Predominately White Institutions and have positive expectancy outcomes of physical activity engagement, it is consistently suggested that MSIs examine and bolster health enhancing avenues. Black and Latina women frequently use social media platforms to connect to content that can initiate and support lifestyle changes or improvements. Thus, establishing culturally relevant health related social media content geared toward Black and Latina College Women (BLCW) may be successful in achieving health-related goals. Therefore, the purpose of this study using social identity theory as a theoretical lens, was to identify the fundamental characteristics of culturally tailored health-related content for BLCW.

Method

This study employed a qualitative approach to ascertain the characteristics of culturally tailored health-related content for BLCW. Black and Latina college women were asked to provide feedback on mock culturally tailored health-related content in semi-structured focus groups. Participants discussed the authenticity and cultural relevancy of images designed to promote physical activity engagement and other healthy behaviors.

Results

Results indicated that at a minimum, culturally tailored health-related content should include an array of body shapes, authentic language and messaging, in relevant settings. Moreover, BLCW prefer content that is realistic, reflects their experiences, and embodies their relevant identities.

Conclusion

Social media content designed to attract and promote healthy lifestyles of BLCW must be comprised of imagery and language that represent the diversity of the priority group. The findings from this study can help to establish best practices when designing content intended to strengthen wellness among college students and young adults.

Social Media Interventions for Patients and Public: Opportunities and Challenges for the Urology Community

Interactive interventions represent a new application of social media in urology that involves multidirectional communication within a group. Such interventions have the potential to influence health behaviours in patients and the public and result in a significant impact on urological diseases.

Gamification as a health education strategy of adolescents at school: Protocol for a systematic review and meta-analysis

The objective of the study is to present a systematic review and meta-analysis protocol for evaluating the effects of health education gamification-based interventions, on health parameters (food consumption, sleep quality and physical activity) of adolescent students. This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022373833). The search will be performed in the following databases: MEDLINE, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, APA, and ADOLEC. Intervention studies (clinical trials - randomized or non-randomized) and quasi-experimental studies will be included. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomized controlled trials, non- randomized controlled trials and quasi-experimental trials. Two independent researchers will conduct all assessments, and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed using RevMan 5.4.1 software. We will conduct the study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guideline. The review will summarize the current evidence on gamification health education changes in parameters related to the health of adolescents. Gamification has been used to verify the increase in adherence to healthy habits or the development of health-related skills, but there are still few results for the adolescent population. We expect that the systematic review could indicate strategies with gamification interventions and also determine how these strategies can improve health parameters of adolescent students, and they will be available as a reference for these interventions.

Social media use and health risk behaviours in young people: systematic review and meta-analysis

OBJECTIVES

To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic, PsyArXiv, medRxiv, and Google Scholar (1 January 1997 to 6 June 2022).

METHODS

Health risk behaviours were defined as use of alcohol, drugs, tobacco, electronic nicotine delivery systems, unhealthy dietary behaviour, inadequate physical activity, gambling, and anti-social, sexual risk, and multiple risk behaviours. Included studies reported a social media variable (ie, time spent, frequency of use, exposure to health risk behaviour content, or other social media activities) and one or more relevant outcomes. Screening and risk of bias assessments were completed independently by two reviewers. Synthesis without meta-analysis based on effect direction and random-effects meta-analyses was used. Effect modification was explored using meta-regression and stratification. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations).

RESULTS

Of 17 077 studies screened, 126 were included (73 included in meta-analyses). The final sample included 1 431 534 adolescents (mean age 15.0 years). Synthesis without meta-analysis indicated harmful associations between social media and all health risk behaviours in most included studies, except inadequate physical activity where beneficial associations were reported in 63.6% of studies. Frequent (v infrequent) social media use was associated with increased alcohol consumption (odds ratio 1.48 (95% confidence interval 1.35 to 1.62); n=383 068), drug use (1.28 (1.05 to 1.56); n=117 646), tobacco use (1.85, 1.49 to 2.30; n=424 326), sexual risk behaviours (1.77 (1.48 to 2.12); n=47 280), anti-social behaviour (1.73 (1.44 to 2.06); n=54 993), multiple risk behaviours (1.75 (1.30 to 2.35); n=43 571), and gambling (2.84 (2.04 to 3.97); n=26 537). Exposure to content showcasing health risk behaviours on social media (v no exposure) was associated with increased odds of use of electronic nicotine delivery systems (1.73 (1.34 to 2.23); n=721 322), unhealthy dietary behaviours (2.48 (2.08 to 2.97); n=9892), and alcohol consumption (2.43 (1.25 to 4.71); n=14 731). For alcohol consumption, stronger associations were identified for exposure to user generated content (3.21 (2.37 to 4.33)) versus marketer generated content (2.12 (1.06 to 4.24)). For time spent on social media, use for at least 2 h per day (v <2 h) increased odds of alcohol consumption (2.12 (1.53 to 2.95); n=12 390). GRADE certainty was moderate for unhealthy dietary behaviour, low for alcohol use, and very low for other investigated outcomes.

CONCLUSIONS

Social media use is associated with adverse health risk behaviours in young people, but further high quality research is needed to establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful.

STUDY REGISTRATION

PROSPERO, CRD42020179766.

Implementing multicomponent, eHealth-based behaviour change support within a dietary intervention trial improves adherence to study-related behaviours in healthy young adults

BACKGROUND

Behaviour change science is proposed to improve participant retention and enhance the validity of trials. However, researchers seldom systematically consider and implement behaviour change strategies within trials for this purpose. The objective of this article is to evaluate how an eHealth behaviour change support (BCS) program enhances young adults' adherence to behaviours required within a dietary intervention.

METHODS

The Nine Principles framework was used to develop BCS to implement across both arms of a 10-week randomised parallel-group intervention to enhance adherence to (i) eating healthily and (ii) reporting dietary intake. Key components of the BCS included access to a dietitian-led Facebook group, text reminders, and food delivery. Effectiveness was measured using the following analyses of the 78 participants who completed the study; pre-post change in targeted dietary habits over time using a subscore of the Healthy Diet Habits Index, questionnaire to assess change in perception of barriers to eating healthily over time, Facebook group engagement, and impact evaluation of the BCS. Participants received a dietary reporting score out of 100 to assess adherence across the 10 weeks.

RESULTS

The total Healthy Diet Habits Index subscore out of 16 significantly increased from baseline to week 10 (10.6 ± 2.6 to 11.2 ± 2.6, p value < 0.05), driven primarily by an increase in vegetable consumption. Overall adherence to reporting was high across the 10 weeks, with the total population mean reporting score 90.4 ± 14.6 out of 100. Relatively low Facebook engagement was observed. Adding objects to the environment, prompts/cues and removing reward appeared to be effective components of the BCS for enhancing adherence to the target behaviours.

CONCLUSION

Using a behaviour change framework to support the design of randomised trials is a promising way to enhance participant adherence to study requirements that are typically considered burdensome, such as dietary reporting. It also enables researchers to identify and replicate effective components of BCS, including behaviour change techniques and modes of delivery. Further research into the use of different behaviour change frameworks for this purpose is warranted.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163 . (03/05/2021).

The quality and reliability of TikTok videos on non-alcoholic fatty liver disease: a propensity score matching analysis

Background

Lifestyle modification is the cornerstone of non-alcoholic fatty liver disease (NAFLD) prevention and treatment. Short video platforms can facilitate easier access to health information for patients, thereby influencing lifestyle changes. An increasing number of individuals rely on online platforms to acquire health-related information about NAFLD. However, the quality of information regarding NAFLD on these platforms remains unclear.

Objective

This study aimed to investigate the quality of information about NAFLD on TikTok.

Methods

A total of 497 videos were retrieved from TikTok. The basic video information, including the video source, was extracted. Two independent raters evaluated the quality and reliability of the videos using the Global Quality Score system and a modified DISCERN tool. Propensity score matching (PSM) was used to compare video quality across sources.

Results

NAFLD-related videos on TikTok were divided into three groups according to the uploader: health professionals, medical institutions, and science bloggers. Overall, the quality of NAFLD videos on TikTok was not satisfactory. Before PSM, there were no significant differences in video quality or content between the three groups. After PSM, the quality of NAFLD videos from health professionals was significantly better than the videos created by other groups. Besides, the videos of health professionals outperformed those of medical institutions and science bloggers in terms of the definition of disease, risk factors, and treatment, but were inferior to those of medical institutions considering the symptoms and tests of NAFLD.

Conclusion

The quality of NAFLD-related videos on TikTok needs improvement. Compared with videos created by science bloggers and medical institutions, videos from health professionals may provide accurate guidance on the treatment and prevention of NAFLD.

Prevalence of heart failure stages in the general population and implications for heart failure prevention: reports from the China Hypertension Survey 2012-15

AIMS

There are no nationwide epidemiological data on heart failure (HF) stages in China. Knowledge of the prevalence of HF stages is crucial for planning HF prevention and management strategies. We aimed to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity.

METHODS AND RESULTS

This is a cross-sectional study and national representative general population aged ≥ 35 years (n = 31 494, mean age 57.4 years, women 54.1%) were obtained from the China Hypertension Survey. Participants were divided into Stage A (at-risk for HF), Stage B (pre-HF), and Stage C (symptomatic HF). Survey weights were calculated based on the 2010 China population census data. The prevalence of Stage A was 35.8% (≈245.1 million), Stage B 42.8% (≈293.1 million), and Stage C 1.1% (≈7.5 million). The prevalence of Stages B and C increased with increasing age (P < 0.0001). Women had lower prevalence of Stage A (32.6% vs. 39.3%; P < 0.0001) but higher prevalence of Stage B (45.9% vs. 39.5%; P < 0.0001) than men. People from rural area had lower prevalence of Stage A (31.9% vs. 41.0%; P < 0.0001) but higher prevalence of Stage B (47.8% vs. 36.2%; P < 0.0001) than people from urban. The prevalence of Stage C was similar by sex and urbanity.

CONCLUSION

The burdens of pre-clinical and clinical HF are high and vary by age, sex, and urbanity in China. Targeted interventions are needed to reduce the high burden of pre-clinical and clinical HF.

Factors Influencing Adolescents’ Use of Social Media for Nutrition Intervention

Adolescents are the largest population using social media in daily life, and their use is influenced by a wide range of factors. Hence, it is applied in nutrition intervention, which improved their health. However, some intervention lacks participation and engagement. This study identifies factors influencing adolescents’ social media use for nutrition interventions. An in-depth interview was conducted virtually for 30 to 60 minutes focusing on nutrition-related matters with 15 adolescents. Almost all of them were interested to participate in nutrition interventions on social media. User characteristics, environmental factors, and social media features were identified as the factors impacting them.

The Impact of Social Media Interventions on Weight Reduction and Physical Activity Improvement Among Healthy Adults: Systematic Review

BACKGROUND

A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions.

OBJECTIVE

This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy.

METHODS

CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis.

RESULTS

A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity; 38% (6/16) of studies investigated weight reduction; and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies.

CONCLUSIONS

Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42022311430; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=311430.

An online mental health informed physical activity intervention for emergency service workers and their families: A stepped-wedge trial

Objective

Emergency service workers are at risk of experiencing poor mental health due to repeated exposure to potentially traumatic events. Promoting healthy lifestyle factors may help improve health outcomes and quality of life among this population. This study aimed to evaluate the efficacy of a 10-week physical activity (PA) and diet programme delivered via Facebook for sedentary emergency service workers and their support partners on levels of psychological distress.

Methods

We delivered a 10-week intervention via a private Facebook group facilitated by exercise physiologists, a dietitian and peer-facilitators. Weekly education modules and telehealth calls were delivered, and participants were provided with a PA tracking device (Fitbit accelerometer). A stepped-wedge design was applied to compare levels of psychological distress (K6) during baseline, to intervention by comparing slopes of change. Secondary pre-post outcomes included mental health symptoms, PA, quality of life, social support to exercise, sleep quality and suicidal ideation.

Results

In total, N=90 participants (n=47 emergency service workers and n=43 support partners) were recruited in 4 cohorts (aged 42.3±11.5 years, 51% male). Levels of psychological distress did not change significantly during the baseline (control) slope and reduced significantly during the first 6 weeks of intervention (intervention slope 1). The slopes were significantly different, b=-0.351, p = 0.003 (i.e. the trajectories of change) and improvements plateaued until follow up. Retention was high (92%) and improvements in mental health symptoms, minutes of PA, sedentary time and quality of life were significant.

Conclusions

Our intervention delivered via social media is feasible and associated with reduced levels of psychological distress among emergency service workers and support partners.

Trial registration

Australian New Zealand Clinical Trials Registry (ACTRN): 12619000877189.

Use of Social Media by Adolescents for Nutrition Intervention: Factors to consider

Adolescents are the largest population using social media in daily life, and their use is influenced by a wide range of factors. Hence, it is applied in nutrition intervention, which improved their health. However, some intervention lacks participation and engagement. This study identifies factors influencing adolescents’ social media use for nutrition interventions. An in-depth interview was conducted virtually for 30 to 60 minutes focusing on nutrition-related matters with 15 adolescents. Almost all of them were interested to participate in nutrition interventions on social media. User characteristics, environmental factors, and social media features were identified as the factors impacting them.

Using Social Media to Collect Dietary Information for Public Health Policy

There is no regular, routine measurement of food and nutrient intake regionally in the UK. Our goal was to identify a method to support policy makers tracking the local population food intakes. The aim of this study was to test the feasibility of using social media to obtain a large sample in a short time, with a regional focus; collecting dietary information using online tools. A Facebook (FB) boost approach was used to recruit a regional (Yorkshire and Humberside) sample of adults to complete a brief online survey followed by a detailed measure of food and nutrient intakes for the previous day using myfood24®. The FB posts were boosted for 21 days and reached 76.9 k individuals. 1428 participants completed the main questionnaire and 673 participants completed the diet diary. The majority of respondents were older women. 22% of respondents reported experiencing moderate food insecurity during 2021. Overall nutrient values recorded were similar to national survey data. Intakes of fibre and iron were low. Despite some challenges, this study has demonstrated the potential to use social media, in this case Facebook, to recruit a large sample in a short timeframe. Participants were able to use online tools to report food and nutrient intakes. This data is relevant to local and national policy makers to monitor and evaluate public health programmes.

Association Between Health Information‒Seeking Behavior on YouTube and Physical Activity Among U.S. Adults: Results From Health Information Trends Survey 2020

Introduction

Although physical activity has many health benefits, 45.8% of U.S. adults did not meet the WHO recommendation in 2018. Delivering health-related content, particularly physical activity, through YouTube may help to overcome some barriers, such as lack of access to resources. This study aimed to examine the association between watching health-related information on YouTube and increased levels of physical activity among U.S. adults.

Methods

Using the U.S. national cross-sectional survey-Health Information National Trends Survey 2020 (n=3,865), we conducted a multivariable logistic regression on obtaining 150 minutes of at least moderate-intensity physical activity per week (WHO guidelines) by watching health-related information on YouTube, controlling for demographics (age, sex, race/ethnicity), socioeconomics (income, education level, insurance coverage, employment), current use of cigarettes and e-cigarettes, use of electronic wearable devices (e.g., Fitbit), self-reported health status, BMI, and the presence of chronic conditions (e.g., diabetes, heart disease, cancer) and depression or anxiety disorders.

Results

Overall, 40.8% (weighted) of respondents reported using YouTube to watch health-related videos, and 39.2% reported meeting the WHO-recommended physical activity level. After controlling for covariates, adults who reported watching health-related videos on YouTube in the past 12 months (versus not watching) were 1.33 times more likely to do 150 minutes or more of moderate physical activity a week (AOR=1.33; 95% CI=1.01, 1.76).

Conclusions

This study suggests that adults who view health-related YouTube videos may be more likely to meet the WHO-recommended level of physical activity. This finding could inform future behavioral interventions using online video platforms to promote physical activity.

Gamification on Instagram: Nursing students' degree of satisfaction with and perception of learning in an educational game

BACKGROUND

Gamification has been shown to lead to greater motivation and participation among students. Currently, many teachers use social networks to share supplementary course materials and student work, but they have not incorporated gamified educational activities into social networking sites.

OBJECTIVE

To determine nursing students' satisfaction with an Instagram-based educational game and their perceptions of its effects on their learning.

DESIGN

We conducted a cross-sectional, descriptive, observational study.

PARTICIPANTS

First-year nursing students in the subject "Dietetics and Nutrition".

RESULTS

Of the total sample, 71.7 % agreed that gamification had helped them assimilate the content. Between 66 % and 70 % agreed that the experience had motivated them to keep up with the subject and learn more about the topic, that it had helped them to better understand certain concepts of the subject, that they would recommend the experience to other students, and that they enjoyed the experience of playing a game while learning. 71.7 % of them were in favour of increased use of gamification in other subjects.

CONCLUSIONS

The use of an Instagram-based educational game as a complement to in-class teaching was useful, enjoyable, and motivating for the acquisition of new knowledge.

The Mediating Effects of Food Content Watching Motivation on the between Watching Time and Nutrition Quotient of Adolescents in Seoul, Korea

Food-related content varies widely and is increasingly popular. Using various media, teenagers can easily access food content, which could affect they eating habits. This study was conducted to confirm the effects of watching motivation on the relationship between food content watching time and eating habits among adolescents in Seoul, Korea. Exactly 806 participants were surveyed about their food content watching status, including watching time and watching motivation. The Nutrition Quotient for adolescents (NQ-A) questionnaire was used to confirm eating habits. Exploratory factor analysis was conducted to classify watching motivation’s subfactors. A parallel multimedia model was used to analyze the effect of watching motivation on the relationship between food content watching time and eating habits. As a result of this study, following the factor analysis, watching motivation was classified into information acquisition, emotional satisfaction, and enjoyment. The influence of food content watching time on NQ-A scores through information acquisition motivation was positively significant, whereas that through emotional satisfaction motivation was negatively significant. Enjoyment motivation did not indirectly affect the relationship between food content watching time and NQ-A scores. Hence, attention should be paid to these mediating factors when analyzing the relationship between watching food-related content and eating habits. Developing and distributing content that meets viewing motivations should help improve adolescents’ eating habits.

The effectiveness of Facebook as a social network intervention to increase physical activity in Chinese young adults

Introduction

Facebook, one of the worlds' most popular online social networks, is easy to access and cost-effective. Its use to enhance individual's physical activity (PA) participation should be examined. This research reviews the effectiveness and successful features of Facebook for influencing PA behaviors in young adults (Study 1), and empirically examines the efficacy of the features purported in increase PA via a Facebook intervention (Study 2).

Methods

In Study 1, PubMed, Medline, SPORT Discus, ERIC, and Embase were searched for articles that identified successful features and effectiveness of Facebook PA interventions published between January 2005 and February 2022. In Study 2, a 4-week Facebook PA intervention with University students was conducted using features identified in Study 1. The PA behaviors with objective (ActiGraph) and subjective (questionnaire) measures, perceived PA level, stage of readiness, effectiveness, and efficiency of Facebook were examined.

Results

Study 1 concluded that the most effective strategies for producing significant PA changes in young adults using a PA Facebook intervention included the following: Adding behavior modification (goal setting and self-monitoring), using influence agents, recruiting members of an existing network with the snowball technique, being attentive to group size, enhancing social support with motivational quotes, interactive posts, opinion polls, increasing tailored feedback, and providing educational information. Study 2 found no significant difference in PA between the intervention and the control groups, as measured objectively, but the subjective reporting of PA behavior was higher in the intervention group. Compared to the control group, the Facebook PA intervention group reported more positive change in perceived stage of readiness in PA participation, commuting type, sport type, sport venue, sport emotion, and fast breathing or sweating. When features were ranked by the Facebook PA intervention group, motivation (supports from your friends) and tailored feedback (the responses from your friends are really personal and fits you) were the top two ranked features.

Conclusion

The use of influence agents in the Facebook PA intervention could address exercise preference and facilitate higher program engagement. Significant differences related to commuting type, sport types, sport venue barriers, and exercise intensity across groups were noteworthy and warrant additional investigation in the future.

Effects of technology-based interventions on dietary intake or anthropometrics among adolescents and adults in South Asia - A systematic review of intervention studies

INTRODUCTION

Mobile technology has been increasingly used as part of dietary interventions, but the effects of such interventions have not been systematically evaluated in the South Asian context. The systematic review aimed to determine the effects of technology-based interventions on dietary intake or anthropometrics among adolescents and adults in South Asia.

METHODS

Five electronic databases were searched (PubMed, Scopus, Web of Science, Global Health Library and Health Technology Assessment). Studies published in English between 1st January 2011 and 31st December 2021were included. Interventions that evaluated the effects of dietary interventions using technology on dietary outcomes and anthropometrics in adolescents or adults in the age group of 13-44 years (or a broader age group) from South Asia were eligible for inclusion. The risk of bias was assessed using the Cochrane Risk-of-bias 2 tool and ROBINS-I tool. A narrative synthesis was conducted.

RESULTS

Twenty-one studies met the inclusion criteria (20,667 participants). Eleven of the 17 randomised controlled trials (RCTs) had a high overall risk of bias. The four non-randomised intervention studies had a serious or critical overall risk of bias. When including studies with low risk or some concern for bias, the interventions had a beneficial effect on at least one dietary outcome in four of the six RCTs that measured changes in diet, and no effect on the anthropometric outcomes in the six RCTs that measured changes in anthropometric outcomes.

DISCUSSION

Technology-based dietary interventions have had some positive effects on dietary intake, but no effects on anthropometry in South Asia. More evidence is needed as the overall risk of bias was high in a majority of the studies.

Social media interventions targeting exercise and diet behaviours in people with noncommunicable diseases (NCDs): A systematic review

BACKGROUND

Noncommunicable diseases (NCDs) are the leading cause of death globally. Promoting physical activity and healthy eating is essential to help manage the NCD burden and reduce mortality. Social media may be a potential platform for delivering and scaling health promotion initiatives. In this systematic review, we aimed to examine i) the feasibility and acceptability of social media interventions targeting physical activity and/or diet for people with NCDs, ii) the effectiveness of improving exercise and diet behaviours, iii) specific design components used to promote user engagement and iv) the effectiveness on other health outcomes.

METHODS

We searched MEDLINE, Google Scholar, CINAHL, EMBASE, and SPORTDiscus from inception until June 2021. Social media interventions targeting physical activity and/or diet were included. Participants were any age, with a diagnosis of one of the following categories of NCDs; cardiovascular disease, cancer, chronic respiratory disease, diabetes or mental illness. Interventions using social media alone or as part of an intervention with other modes of delivery were included. Eligible study designs were randomised controlled trials (RCTs), non-randomised controlled trials, feasibility or pilot studies, or quasi-experimental studies.

RESULTS

A total of 2358 publications were identified. After removal of duplicates, 2233 publication titles and abstracts were screened, and 10 publications were eligible, describing 8 individual studies. The study designs included five RCTs and three pilot or feasibility studies, all published between 2016 and 2020. Sample sizes ranged from n = 11 to n = 312. Half of the studies were conducted in the United States of America. Clinical populations included severe mental illness (2 studies), cardiovascular disease (2 studies), chronic obstructive pulmonary disease (2 studies), cancer (1 study) and Type 2 diabetes (1 study). Facebook (three studies) and WeChat (three studies) were the most used social media platforms. The majority utilised social media to deliver health education and facilitate social support and all studies reported >70% retention. Four of the five included RCTS reported significant improvements in exercise behaviours (e.g., step count, exercise capacity) while diet was only assessed in two studies and results were non-significant.

CONCLUSIONS

Social media interventions appear to be feasible and acceptable among specific NCD populations and preliminary evidence suggests interventions they may be effective for improving exercise behaviours. The evidence for diet behaviours remains unclear. While overall there is an emerging evidence base, more rigorous evaluation including replication studies are needed to determine the efficacy of social media interventions.

Investigating Web-Based Nutrition Education Interventions for Promoting Sustainable and Healthy Diets in Young Adults: A Systematic Literature Review

Background: Our current rapidly growing food systems are imposing a heavy burden on both environmental sustainability and human health. Sustainable and healthy diets aim to promote optimal health and have a minimal environmental impact. This study aimed to critically review and synthesise the evidence on the effectiveness of web-based nutrition education interventions aiming to promote sustainable and healthy diets among young adults. Methods: A systematic search of four databases (Medline, PsycINFO, Scopus, and Embase) was conducted in March 2021. Studies were included if they used an online platform to deliver the intervention to young adults and measured at least one aspect of sustainable and healthy diets, such as plant-based food intake, food waste, and local and seasonal produce. Of the 2991 studies, a total of 221 full-text articles were assessed for eligibility of which 22 were included in the final review. Results: A majority of the studies (82%) targeted fruit and vegetable consumption, and close to a quarter of studies (23%) targeted other aspects of a sustainable and healthy diet, such as red meat intake. Only one study included multiple aspects of a sustainable and healthy diet. Program delivery outcomes reported overall positive feedback and engagement. Conclusion: This review suggests that web-based interventions may be effective in promoting some sustainable diet-related outcomes in young adults. However, there is a need for developing and evaluating future programs to promote sustainable diets more comprehensively in order to help young adults make healthy and sustainable food choices.

What Happened in 'The HERizon Project'?-Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls

This mixed-methods process evaluation examines the reach, recruitment, fidelity, adherence, acceptability, mechanisms of impact, and context of remote 12-week physical activity (PA) interventions for adolescent girls named The HERizon Project. The study was comprised of four arms-a PA programme group, a behaviour change support group, a combined group, and a comparison group. Data sources included intervention deliverer and participant logbooks (100 and 71% respective response rates, respectively), exit surveys (72% response rate), and semi-structured focus groups/interviews conducted with a random subsample of participants from each of the intervention arms (n = 34). All intervention deliverers received standardised training and successfully completed pre-intervention competency tasks. Based on self-report logs, 99% of mentors adhered to the call guide, and 100% of calls and live workouts were offered. Participant adherence and intervention receipt were also high for all intervention arms. Participants were generally satisfied with the intervention components; however, improvements were recommended for the online social media community within the PA programme and combined intervention arms. Autonomy, sense of accomplishment, accountability, and routine were identified as factors facilitating participant willingness to adhere to the intervention across all intervention arms. Future remote interventions should consider structured group facilitation to encourage a genuine sense of community among participants.

Development of Reporting Guidelines for Social Media Research (RESOME) using a modified Delphi Method: Study protocol (Preprint)

Background

Objective

Methods

Results

Conclusions

International Registered Report Identifier (IRRID)