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

Quitting on TikTok: Effects of Message Themes, Frames, and Sources on Engagement with Vaping Cessation Videos

This study examined how message themes, frames, and sources in vaping cessation videos on TikTok influenced positive (i.e. likes, shares, positive comments regarding quitting vaping) and negative video engagement (i.e. negative comments regarding quitting vaping). TikTok videos (N = 412) with the hashtags #quitvaping and #quittingvaping were analyzed. Aspect-based sentiment analysis was conducted to evaluate the sentiment of quitting vaping in comments. Negative binomial regression models predicted video engagement from six message themes, ratios of gain and loss frames, and message sources. Themes related to nicotine addiction and physical health effectively drove positive engagement, such as likes and shares. The theme of harmful chemicals elicited mixed responses, generating both positive and negative comments regarding quitting vaping. Videos with a higher ratio of gain frames led to more positive engagement, including likes, shares, and positive comments regarding quitting vaping. Sources with informal expertise (e.g. those who have successfully quit vaping) and current e-cigarette users were more effective in engaging the TikTok audience than non-expert and non-user sources. These findings provide insights into messaging strategies that can effectively engage TikTok audiences and encourage vaping cessation.

Addressing Antivaccine Sentiment on Public Social Media Forums Through Web-Based Conversations Based on Motivational Interviewing Techniques: Observational Study

BACKGROUND

Health misinformation shared on social media can have negative health consequences; yet, there is a dearth of field research testing interventions to address health misinformation in real time, digitally, and in situ on social media.

OBJECTIVE

We describe a field study of a pilot program of "infodemiologists" trained with evidence-informed intervention techniques heavily influenced by principles of motivational interviewing. Here we provide a detailed description of the nature of infodemiologists' interventions on posts sharing misinformation about COVID-19 vaccines, present an initial evaluation framework for such field research, and use available engagement metrics to quantify the impact of these in-group messengers on the web-based threads on which they are intervening.

METHODS

We monitored Facebook (Meta Platforms, Inc) profiles of news organizations marketing to 3 geographic regions (Newark, New Jersey; Chicago, Illinois; and central Texas). Between December 2020 and April 2021, infodemiologists intervened in 145 Facebook news posts that generated comments containing either false or misleading information about vaccines or overt antivaccine sentiment. Engagement (emojis plus replies) data were collected on Facebook news posts, the initial comment containing misinformation (level 1 comment), and the infodemiologist's reply (level 2 reply comment). A comparison-group evaluation design was used, with numbers of replies, emoji reactions, and engagements for level 1 comments compared with the median metrics of matched comments using the Wilcoxon signed rank test. Level 2 reply comments (intervention) were also benchmarked against the corresponding metric of matched reply comments (control) using the Wilcoxon signed rank test (paired at the level 1 comment level). Infodemiologists' level 2 reply comments (intervention) and matched reply comments (control) were further compared using 3 Poisson regression models.

RESULTS

In total, 145 interventions were conducted on 132 Facebook news posts. The level 1 comments received a median of 3 replies, 3 reactions, and 7 engagements. The matched comments received a median of 1.5 (median of IQRs 3.75) engagements. Infodemiologists made 322 level 2 reply comments, precipitating 189 emoji reactions and a median of 0.5 (median of IQRs IQR 0) engagements. The matched reply comments received a median of 1 (median of IQRs 2.5) engagement. Compared to matched comments, level 1 comments received more replies, emoji reactions, and engagements. Compared to matched reply comments, level 2 reply comments received fewer and narrower ranges of replies, reactions, and engagements, except for the median comparison for replies.

CONCLUSIONS

Overall, empathy-first communication strategies based on motivational interviewing garnered less engagement relative to matched controls. One possible explanation is that our interventions quieted contentious, misinformation-laden threads about vaccines on social media. This work reinforces research on accuracy nudges and cyberbullying interventions that also reduce engagement. More research leveraging field studies of real-time interventions is needed, yet data transparency by technology platforms will be essential to facilitate such experiments.

A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review

BACKGROUND

Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal.

OBJECTIVE

This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes.

METHODS

We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects.

RESULTS

We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages.

CONCLUSIONS

Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement."

TRIAL REGISTRATION

PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.

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

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

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

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

Youth social innovation during the COVID-19 pandemic in the Philippines: a quantitative and qualitative descriptive analyses from a crowdsourcing open call and online hackathon

Introduction

Young people have played a pivotal role as part of the COVID-19 response, including developing health messages and social innovations. Social innovation in health engages multiple stakeholders in linking social change and health improvement. The study examined the feasibility of youth ideas and innovations to address the impacts of the COVID-19 pandemic using quantitative and qualitative descriptive analyses.

Methods

In partnership with the WHO, academic institutions, youth organisations and civil society groups, we conducted a crowdsourcing open call among Filipino youth (15–30 years old) using a structured Special Programme for Research and Training in Tropical Diseases/Social Innovation in Health Initiative process. The open call had three categories: youth voices to cocreate the post-COVID-19 world (entries were texts, images, videos and music), youth-led COVID-19 social innovations, and youth-led social innovations not related to COVID-19. Each submission was evaluated by three independent judges. Finalists were selected in each of the categories alongside four grand winners. All finalists were invited to attend a 1 day online civic hackathon.

Results

We received a total of 113 entries (youth voices to cocreate the post-COVID world=76; youth-led COVID-19 social innovations=17; youth-led social innovations not related to COVID-19=20). Twelve entries focused on youth mental health during the pandemic. The online hackathon provided the participants mentorship for further development of their ideas. Finalists were able to produce draft health communication campaigns and improved social innovations.

Conclusion

Many Filipino youth created exceptional entries in response to the open call. This suggests the feasibility of including youth voices in strategic planning processes. A global youth social innovation call is recommended.

Online reach and engagement of a child nutrition peer-education program (PICNIC): insights from social media and web analytics

BACKGROUND

Parents frequently seek parental advice online and on social media; thus, these channels should be better utilized in child health interventions. The Parents in Child Nutrition Informing Community (PICNIC) program aims to facilitate peer-to-peer sharing of evidence-based child feeding information and support parents within their social networks. The present study aimed to explore web and social media analytics to evaluate reach and user engagement with the PICNIC online components.

METHODS

Online user activity data from the PICNIC Facebook closed group and public Page were collected through Facebook Insights, and program-specific website traffic data through Google Analytics. Analytics data from Nov-2019 to April-2021 was evaluated through visualisation and summary statistics to obtain insights into program growth and current reach in Australia, compare demographics of audience reached through the online channels, and explore parents' use and engagement in PICNIC content.

RESULTS

Results showed steady program growth in the 18 months of recruitment; participant numbers grew from 102 to 261 peer educators while the Facebook Page audience increased threefold, totalling 1615 followers. Intervention posts shared on Facebook (4-5 posts/week) typically reached only a portion of PICNIC Page followers each week, but also reached a wider audience through their friends. Throughout the evaluated period, Facebook users actively engaged in PICNIC posts, although the level of engagement varied considerably from post to post. Furthermore, results from this study suggest the strategy of directing potentially interested parents from social media to the website for program sign-up was successful. Finally, the explored data gave insights into users' availability, demographics and engagement, which will be used to inform refinement of the PICNIC website and social media strategies.

CONCLUSIONS

Our findings confirm the benefits of using a peer education approach and existing social network channels to disseminate evidence-based child feeding information to parents. This study also demonstrates the usefulness of web and social media analytics to be used as part of a continuous evaluation for gaining insight to inform further development and improvement of program strategies.

TRIAL REGISTRATION

The PICNIC project was retrospectively submitted for registration with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622000230752 (09/02/2022).

Atividade das Unidades de Saúde Familiares da Área Metropolitana do Porto no Facebook em ano de COVID-19

Introdução: As redes sociais têm possibilitado, nos últimos anos, novas formas de interação entre pessoas e entidades e a partilha escalável de conteúdos de diversas áreas, embora nem sempre de forma criteriosa. Objetivos: Caracterizar a presença de páginas das Unidades de Saúde Familiar da Área Metropolitana do Porto (Portugal) na plataforma Facebook à data de dezembro de 2020, suas métricas de idade, seguidores, publicações e interações num dado intervalo de tempo e sua distribuição por modelo organizacional (Unidades de Saúde Familiar–A/B) e Agrupamento de Centros de Saúde; verificar a tendência de criação de páginas em 2020 – ano de pandemia por COVID-19 – e aferir as temáticas abordadas pelas 50 publicações dos últimos 60 dias que obtiveram mais interações. Métodos: Estudo exploratório transversal, descritivo e analítico, com verificação individual das páginas das Unidades de Saúde Familiar da Área Metropolitana do Porto a 30 de dezembro de 2020 e obtenção de métricas relativas a um intervalo de 60 dias de atividade por meio da página Fanpage Karma. Foram calculadas frequências, intervalos, médias e medianas e aplicados testes paramétricos e não paramétricos. Resultados: Das 135 Unidades de Saúde Familiar funcionantes (64% Unidades de Saúde Familiar–B), 53% tinham página ativa (61% Unidades de Saúde Familiar–B, p<0,05), variando entre 0 e 81,3% das Unidades de Saúde Familiar em cada Agrupamento de Centros de Saúde, criadas nos últimos dez anos (mediana 4,6 anos, Unidades de Saúde Familiar–A 1,5 versus Unidades de Saúde Familiar–B 5,3, p<0,05), com crescimento de 44% no ano de 2020. O número de seguidores distribui-se heterogeneamente entre diferentes Unidades de Saúde Familiar e Agrupamento de Centros de Saúde, contudo sem diferenças entre modelos de Unidades de Saúde Familiar, não ultrapassando o milhar em 69% das páginas, e com apenas cinco páginas alcançando mais de 2 mil seguidores. Das páginas ativas, 75% (54/72) publicaram em média 0,3 vez por dia nos últimos 60 dias. Não se verificam associações significativas entre o número de seguidores ou entre modelos Unidades de Saúde Familiar–A/B e o tempo da última publicação ou o número de publicações a 60 dias. Durante esse tempo, foram geradas 15.913 interações (média de 18,8 por publicação). Analisadas as 50 publicações com mais interações dos últimos 60 dias, verifica-se o predomínio de temas relacionados com a COVID-19 e com questões organizacionais e burocráticas, efemérides relativas às Unidades de Saúde Familiar e informação/promoção da vacina contra a COVID-19. Discussão: Admite-se haver aplicação reduzida pelas Unidades de Saúde Familiar (embora crescente em ano de pandemia) do potencial comunicacional e colaborativo das redes sociais. Havendo margem de progressão, estas podem constituir uma ferramenta complementar e interativa para a promoção do acesso e a melhoria da qualidade dos serviços, o combate à desinformação, a capacitação para a saúde dos cidadãos e a melhoria de resultados em saúde.

Evaluating the effectiveness of Internet-based communication for public health: a systematic review (Preprint)

Background

Communicating strategically is a key issue for health organizations. Over the past decade, health care communication via social media and websites has generated a great deal of studies examining different realities of communication strategies. However, when it comes to systematic reviews, there is fragmentary evidence on this type of communication.

Objective

The aim of this systematic review was to summarize the evidence on web institutional health communication for public health authorities to evaluate possible aim-specific key points based on these existing studies.

Methods

Guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, we conducted a comprehensive review across 2 electronic databases (PubMed and Web of Science) from January 1, 2011, to October 7, 2021, searching for studies investigating institutional health communication. In total, 2 independent researchers (AN and SS) reviewed the articles for inclusion, and the assessment of methodological quality was based on the Kmet appraisal checklist.

Results

A total of 78 articles were selected. Most studies (35/78, 45%) targeted health promotion and disease prevention, followed by crisis communication (24/78, 31%), general health (13/78, 17%), and misinformation correction and health promotion (6/78, 8%). Engagement and message framing were the most analyzed aspects. Few studies (14/78, 18%) focused on campaign effectiveness. Only 23% (18/78) of the studies had an experimental design. The Kmet evaluation was used to distinguish studies presenting a solid structure from lacking studies. In particular, considering the 0.75-point threshold, 36% (28/78) of the studies were excluded. Studies above this threshold were used to identify a series of aim-specific and medium-specific suggestions as the communication strategies used differed greatly.

Conclusions

Overall, the findings suggest that no single strategy works best in the case of web-based health care communication. The extreme variability of outcomes and the lack of a unitary measure for assessing the end points of a specific campaign or study lead us to reconsider the tools we use to evaluate the efficacy of web-based health communication.

Using Social Media to Engage Knowledge Users in Health Research Priority Setting: Scoping Review

Background

The need to include individuals with lived experience (ie, patients, family members, caregivers, researchers, and clinicians) in health research priority setting is becoming increasingly recognized. Social media–based methods represent a means to elicit and prioritize the research interests of such individuals, but there remains sparse methodological guidance on how best to conduct these social media efforts and assess their effectiveness.

Objective

This review aims to identify social media strategies that enhance participation in priority-setting research, collate metrics assessing the effectiveness of social media campaigns, and summarize the benefits and limitations of social media–based research approaches, as well as recommendations for prospective campaigns.

Methods

We searched PubMed, Embase, Cochrane Library, Scopus, and Web of Science from database inception until September 2021. Two reviewers independently screened all titles and abstracts, as well as full texts for studies that implemented and evaluated social media strategies aimed at engaging knowledge users in research priority setting. We subsequently conducted a thematic analysis to aggregate study data by related codes and themes.

Results

A total of 23 papers reporting on 22 unique studies were included. These studies used Facebook, Twitter, Reddit, websites, video-calling platforms, emails, blogs, e-newsletters, and web-based forums to engage with health research stakeholders. Priority-setting engagement strategies included paid platform–based advertisements, email-embedded survey links, and question-and-answer forums. Dissemination techniques for priority-setting surveys included snowball sampling and the circulation of participation opportunities via internal members’ and external organizations’ social media platforms. Social media campaign effectiveness was directly assessed as number of clicks and impressions on posts, frequency of viewed posts, volume of comments and replies, number of times individuals searched for a campaign page, and number of times a hashtag was used. Campaign effectiveness was indirectly assessed as numbers of priority-setting survey responses and visits to external survey administration sites. Recommendations to enhance engagement included the use of social media group moderators, opportunities for peer-to-peer interaction, and the establishment of a consistent tone and brand.

Conclusions

Social media may increase the speed and reach of priority-setting participation opportunities leading to the development of research agendas informed by patients, family caregivers, clinicians, and researchers. Perceived limitations of the approach include underrepresentation of certain demographic groups and addressing such limitations will enhance the inclusion of diverse research priority opinions in future research agendas.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Analysis of Information About Medicines Available on Facebook

There are many anxieties have been shown and perceived by the experts for SMP of medicines. This procedure of DTCA can be reciprocated, and one of the reason is the platform is uncontrolled; the advantages of the medicines could be exaggerated compared to the disadvantages. Also, patients can share their own experience of using medicine on social networking sites. There is a high probability for the patients to be exposed to ambiguous, contradicting, and confusing information about medicines on social media. Our focal point is to inspect how drug pages in social media influencing the overall population or web-based media clients. We tried to investigate the data available on Facebook pages of popular drugs. Many social media users often go through the content posted on social networking sites. Patients and their family members are likely to be exposed to drug product claims while looking for information about medicines of a specific disease on social media.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Facebook-Based Social Marketing to Reduce Smoking in Australia's First Nations Communities: An Analysis of Reach, Shares, and Likes

BACKGROUND

Facebook is widely used by Australia's First Nations people and has significant potential to promote health. However, evidence-based guidelines for its use in health promotion are lacking. Smoking prevalence among Australia's First Nations people is nearly 3 times higher than other Australians. Locally designed programs in Aboriginal Community Controlled Health Services (ACCHOs) to reduce smoking often use Facebook.

OBJECTIVE

This study reports on an analysis of the reach and engagement of Facebook posts with smoking prevention and cessation messages posted by ACCHOs in the Northern Territory, Australia.

METHODS

Each service posted tobacco control content at least weekly for approximately 6 months. Posts were coded for the following variables: service posted, tailored First Nations Australian content, local or nonlocally produced content, video or nonvideo, communication technique, and emotional appeal. The overall reach, shares, and reactions were calculated.

RESULTS

Compared with posts developed by the health services, posts with content created by other sources had greater reach (adjusted incident rate ratio [IRR] 1.92, 95% CI 1.03-3.59). Similarly, reactions to posts (IRR 1.89, 95% CI 1.40-2.56) and shared posts (IRR 2.17, 95% CI 1.31-3.61) with content created by other sources also had more reactions, after controlling for reach, as did posts with local First Nations content compared with posts with no First Nations content (IRR 1.71, 95% CI 1.21-2.34).

CONCLUSIONS

Facebook posts with nonlocally produced content can be an important component of a social media campaign run by local health organizations. With the exception of nonlocally produced content, we did not find a definitive set of characteristics that were clearly associated with reach, shares, and reactions. Beyond reach, shares, and likes, further research is needed to understand the extent that social media content can influence health behavior.

Learning the Language of Social Media: A Comparison of Engagement Metrics and Social Media Strategies Used by Food and Nutrition-Related Social Media Accounts

Health promoters have been unable to reach and engage people on social media (SM) to the extent that food industry brands and lifestyle personalities have. The objective of this study was to identify the SM post strategies associated with higher engagement in nutrition and food-related posts using a retrospective content analysis. The six most engaging posts from both Facebook and Instagram’s 10 most successful nutrition and food-related accounts were analysed across four fields. Subjective and objective post strategies were coded on 736 posts, and associations with engagement were explored using the Least Absolute Shrinkage and Selection Operator (LASSO). Lifestyle personalities recorded the highest absolute engagement, while health promoters recorded the highest engagement relative to follower count. Strategies associated with higher Facebook engagement included using hashtags and prompting engagement through announcements, while on Instagram, higher engagement was associated with higher caption counts, providing health information links, prompting engagement through strategies that require an action, and using humorous strategies. Strategies associated with lower Instagram engagement included reposted content, general encouragement to eat strategies, encouragement to exercise strategies, not inducing any emotion/hedonic sensations, and providing a negative tone. Health promoters should adapt SM posts to the different SM platforms and utilise strategies associated with higher engagement to engage with their audience on SM.

Review of Evaluation Metrics Used in Digital and Traditional Tobacco Control Campaigns

BACKGROUND

Mass media campaigns for public health are increasingly using digital media platforms, such as web-based advertising and social media; however, there is a lack of evidence on how to best use these digital platforms for public health campaigns. To generate this evidence, appropriate campaign evaluations are needed, but with the proliferation of digital media-related metrics, there is no clear consensus on which evaluation metrics should be used. Public health campaigns are diverse in nature, so to facilitate analysis, this review has selected tobacco control campaigns as the scope of the study.

OBJECTIVE

This literature review aimed to examine how tobacco control campaigns that use traditional and digital media platforms have been evaluated.

METHODS

Medicine and science databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus), and a marketing case study database (World Advertising Research Center) were searched for articles published between 2013 and 2018. Two authors established the eligibility criteria and reviewed articles for inclusion. Individual campaigns were identified from the articles, and information on campaigns and their evaluations were supplemented with searches on Google, Google Scholar, and social media platforms. Data about campaign evaluations were tabulated and mapped to a conceptual framework.

RESULTS

In total, 17 campaigns were included in this review, with evaluations reported on by 51 articles, 17 marketing reports, and 4 grey literature reports. Most campaigns were from English-speaking countries, with behavioral change as the primary objective. In the process evaluations, a wide range of metrics were used to assess the reach of digital campaign activities, making comparison between campaigns difficult. Every campaign in the review, except one, reported some type of engagement impact measure, with website visits being the most commonly reported metric (11 of the 17 campaigns). Other commonly reported evaluation measures identified in this review include engagement on social media, changes in attitudes, and number of people contacting smoking cessation services. Of note, only 7 of the 17 campaigns attempted to measure media platform attribution, for example, by asking participants where they recalled seeing the campaign or using unique website tracking codes for ads on different media platforms.

CONCLUSIONS

One of the key findings of this review is the numerous and diverse range of measures and metrics used in tobacco control campaign evaluations. To address this issue, we propose principles to guide the selection of digital media-related metrics for campaign evaluations, and also outline a conceptual framework to provide a coherent organization to the diverse range of metrics. Future research is needed to specifically investigate whether engagement metrics are associated with desired campaign outcomes, to determine whether reporting of engagement metrics is meaningful in campaign evaluations.

"Study Natural" without Drugs: An Exploratory Study of Theory-Guided and Tailored Health Campaign Interventions to Prevent Nonmedical Use of Prescription Stimulants in College Students

Nonmedical use of prescription stimulants (NMUPS) among college students continues to rise. While some anti-NMUPS campaigns are available, little is known about the campaign development process and how well college students evaluate these messages. To bridge this gap, we developed theory-guided anti-NMUPS campaign interventions that are tailored to college students’ characteristics and evaluated students’ response towards them. A total of 445 college students (74.4% female; Mean_age of 20; 18 to 35 years old) reviewed the campaign interventions and offered their evaluation via an online survey. Findings indicate that students responded to the campaigns positively. Results also indicate that female students are more likely to perceive the campaigns as effective than their male counterparts. Overall, the findings of this study suggest that theory-guided and tailored anti-NMUPS campaigns have great potential in changing students’ attitudes and behavior towards NMUPS. While this study fills critical gaps in the literature, considering the progress needed to strengthen the research field, more research is needed to further identify effective strategies that could prevent college students’ participation in NMUPS activities.

Using social media for vaccination promotion: Practices and challenges

OBJECTIVE

Vaccination misinformation is widespread on social media. Vaccine-promoting organisations are working to curb its influence, but face obstacles. We aimed to analyse their social media strategies and the challenges they encounter.

METHODS

In this qualitative study, we purposively sampled 21 participants responsible for social media from vaccine-promoting organisations. We used Framework Analysis to explore the data.

RESULTS

Vaccine-promoting organisations faced obstacles using social media, including fast-paced change, limited resources, and insufficient organisational buy-in. They experienced difficulties reaching audiences, exploiting social media listening, and measuring impact. Consequently, they may miss opportunities to counter misinformation, connect with groups low in vaccine confidence, and determine diverse audience responses. They lack strong evidence linking social media strategies with behaviour change, and have difficulty understanding silent audiences.

CONCLUSIONS

Vaccine-promoting organisations have an opportunity to embrace the participatory nature of social media. They could share listening insights with like-minded groups, and conduct research exploring associations between social media strategies and community attitude/behaviour change. Social media platforms could assist by renewing vaccine-promoting organisations' organic reach, supporting the development of tailored listening and credibility tools, and strengthening collaborations to promote credible content.