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Mora Pinzon M, Hills O, Levy G, James TT, Benitez A, Lawrence S, Ellis T, Washington V, Solorzano L, Tellez-Giron P, Cano Ospina F, Metoxen MF, Gleason CE. Implementation of a Social Media Strategy for Public Health Promotion in Black, American Indian or Alaska Native, and Hispanic or Latino Communities During the COVID-19 Pandemic: Cross-Sectional Study. J Med Internet Res 2024; 26:e58581. [PMID: 39657164 DOI: 10.2196/58581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/17/2024] [Accepted: 09/25/2024] [Indexed: 12/14/2024] Open
Abstract
BACKGROUND Individuals identifying as Black, American Indian or Alaska Native, or Hispanic or Latino lack access to culturally appropriate accurate information and are the target of disinformation campaigns, which create doubt in science and health care providers and might play a role in sustaining health disparities related to the COVID-19 pandemic. OBJECTIVE This study aims to create and disseminate culturally and medically appropriate social media messages for Black, Latino, and American Indian or Alaska Native communities in Wisconsin and evaluate their reach and effectiveness in addressing the information needs of these communities. METHODS Our team identified relevant COVID-19 topics based on feedback from their respective community, developed lay format materials, and translated materials into culturally appropriate social media messages that community advocates delivered across their respective communities. Social media metrics (reach, engagement, and impressions) were collected using Sprout Social and Facebook Analytics. We hosted 9 focus groups with community members to learn about their social media use. These data were analyzed using an inductive approach, using NVivo software (release 1.7) to code content. RESULTS Between August 2021 and January 2023, we created 980 unique social media posts that reached 88,790 individuals and gathered >6700 engagements. Average reach per post was similar across the 3 communities, despite differences in the number of posts and followers on each page: 119.46 (Latino individuals), 111.74 (Black individuals), and 113.11 (Oneida Nation members). The type of posts that had higher engagement rate per reached person (ERR) varied across communities and platforms, with the highest being live videos for the Latino community on Facebook (ERR 9.4%), videos for the Black community on Facebook (ERR 19.53%), and social media messages for the Oneida Nation community (ERR 59.01%). CONCLUSIONS Our project presents a unique and effective model for health messages and highlights the need for tailoring social media messages and approaches for minoritized audiences (eg, age, gender, race, and ethnicity). Further research studies are needed to explore how specific types of information affect the dissemination of information and the implications for health communications.
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Affiliation(s)
- Maria Mora Pinzon
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Ornella Hills
- Department of Ethnic Studies, College of Arts and Sciences, Lawrence University, Appleton, WI, United States
| | - George Levy
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Taryn T James
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Ashley Benitez
- School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Sacheen Lawrence
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Tiffany Ellis
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | | | | | | | | | - Melissa F Metoxen
- Native American Center for Health Professions, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
| | - Carey E Gleason
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
- Wisconsin Alzheimer's Disease Research Center, Department of Medicine, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, WI, United States
- Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Department of Veterans Affairs, Madison, WI, United States
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Boby M, Oh H, Marsiglia F, Liu L. Bridging social capital among Facebook users and COVID-19 cases growth in Arizona. Soc Sci Med 2024; 360:117313. [PMID: 39270574 PMCID: PMC11490370 DOI: 10.1016/j.socscimed.2024.117313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 08/02/2024] [Accepted: 09/07/2024] [Indexed: 09/15/2024]
Abstract
Social capital is an important social determinant of health, more specifically bridging social capital, which connects individuals and communities across societal divides. This article reports on the findings of a study about the relationship between bridging social capital and COVID-19 infection trends within the state of Arizona from October 2020 to November 2021. Economic connectedness (EC), derived from Facebook friendship connections, served as a measure of aggregated bridging social capital among residents in each ZCTA (ZIP code tabulation area). Analysis of 192 ZCTAs in Arizona revealed that below-median SES individuals had fewer above-median SES friends (mean EC = 0.86). Multiple linear regression analyses were conducted to assess the correlation between EC and biweekly COVID-19 case growth, adjusting for other social determinants of health. Results showed that higher EC was associated with slower biweekly COVID-19 case growth (p < 0.001). This suggests that bridging social capital plausibly facilitated members of underserved and vulnerable groups to better access health-related information during the COVID-19 pandemic, thereby reducing the risks of infection during the pandemic. These findings suggest that promoting bridging social capital, particularly through social network sites, could be leveraged during early phase of public health crisis. The article concludes by recommending to strengthening bridging social capital for individuals with limited access to public health information and medical care.
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Affiliation(s)
- Maria Boby
- School of Social Work, Arizona State University, United States
| | - Hyunsung Oh
- School of Social Work, Arizona State University, United States.
| | | | - Li Liu
- College of Health Solutions, Arizona State University, United States; Biodesign Institute, Arizona State University, United States
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Kim S, Kim K, Wonjeong Jo C. Accuracy of a large language model in distinguishing anti- and pro-vaccination messages on social media: The case of human papillomavirus vaccination. Prev Med Rep 2024; 42:102723. [PMID: 38659997 PMCID: PMC11039308 DOI: 10.1016/j.pmedr.2024.102723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
Objective Vaccination has engendered a spectrum of public opinions, with social media acting as a crucial platform for health-related discussions. The emergence of artificial intelligence technologies, such as large language models (LLMs), offers a novel opportunity to efficiently investigate public discourses. This research assesses the accuracy of ChatGPT, a widely used and freely available service built upon an LLM, for sentiment analysis to discern different stances toward Human Papillomavirus (HPV) vaccination. Methods Messages related to HPV vaccination were collected from social media supporting different message formats: Facebook (long format) and Twitter (short format). A selection of 1,000 human-evaluated messages was input into the LLM, which generated multiple response instances containing its classification results. Accuracy was measured for each message as the level of concurrence between human and machine decisions, ranging between 0 and 1. Results Average accuracy was notably high when 20 response instances were used to determine the machine decision of each message: .882 (SE = .021) and .750 (SE = .029) for anti- and pro-vaccination long-form; .773 (SE = .027) and .723 (SE = .029) for anti- and pro-vaccination short-form, respectively. Using only three or even one instance did not lead to a severe decrease in accuracy. However, for long-form messages, the language model exhibited significantly lower accuracy in categorizing pro-vaccination messages than anti-vaccination ones. Conclusions ChatGPT shows potential in analyzing public opinions on HPV vaccination using social media content. However, understanding the characteristics and limitations of a language model within specific public health contexts remains imperative.
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Affiliation(s)
- Soojong Kim
- Department of Communication, University of California Davis, United States
| | - Kwanho Kim
- Department of Communication, Cornell University, United States
| | - Claire Wonjeong Jo
- Department of Communication, University of California Davis, United States
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Béres F, Michaletzky TV, Csoma R, Benczúr AA. Network embedding aided vaccine skepticism detection. APPLIED NETWORK SCIENCE 2023; 8:11. [PMID: 36811026 PMCID: PMC9933796 DOI: 10.1007/s41109-023-00534-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
We investigate automatic methods to assess COVID vaccination views in Twitter content. Vaccine skepticism has been a controversial topic of long history that has become more important than ever with the COVID-19 pandemic. Our main goal is to demonstrate the importance of network effects in detecting vaccination skeptic content. Towards this end, we collected and manually labeled vaccination-related Twitter content in the first half of 2021. Our experiments confirm that the network carries information that can be exploited to improve the accuracy of classifying attitudes towards vaccination over content classification as baseline. We evaluate a variety of network embedding algorithms, which we combine with text embedding to obtain classifiers for vaccination skeptic content. In our experiments, by using Walklets, we improve the AUC of the best classifier with no network information by. We publicly release our labels, Tweet IDs and source codes on GitHub.
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Affiliation(s)
- Ferenc Béres
- ELKH Institute for Computer Science and Control (SZTAKI), Kende u. 13-17, Budapest, 1111 Hungary
| | | | - Rita Csoma
- Eötvös Loránd University, Pázmány Péter s. 1, Budapest, 1117 Hungary
| | - András A. Benczúr
- ELKH Institute for Computer Science and Control (SZTAKI), Kende u. 13-17, Budapest, 1111 Hungary
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Ginossar T, Cruickshank IJ, Zheleva E, Sulskis J, Berger-Wolf T. Cross-platform spread: vaccine-related content, sources, and conspiracy theories in YouTube videos shared in early Twitter COVID-19 conversations. Hum Vaccin Immunother 2022; 18:1-13. [PMID: 35061560 PMCID: PMC8920146 DOI: 10.1080/21645515.2021.2003647] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 12/11/2022] Open
Abstract
High uptake of vaccinations is essential in fighting infectious diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the ongoing coronavirus disease 2019 (COVID-19) pandemic. Social media play a crucial role in propagating misinformation about vaccination, including through conspiracy theories and can negatively impact trust in vaccination. Users typically engage with multiple social media platforms; however, little is known about the role and content of cross-platform use in spreading vaccination-related information. This study examined the content and dynamics of YouTube videos shared in vaccine-related tweets posted to COVID-19 conversations before the COVID-19 vaccine rollout. We screened approximately 144 million tweets posted to COVID-19 conversations and identified 930,539 unique tweets in English that discussed vaccinations posted between 1 February and 23 June 2020. We then identified links to 2,097 unique YouTube videos that were tweeted. Analysis of the video transcripts using Latent Dirichlet Allocation topic modeling and independent coders indicate the dominance of conspiracy theories. Following the World Health Organization's declaration of the COVID-19 outbreak as a public health emergency of international concern, anti-vaccination frames rapidly transitioned from claiming that vaccines cause autism to pandemic conspiracy theories, often featuring Bill Gates. Content analysis of the 20 most tweeted videos revealed that the majority (n = 15) opposed vaccination and included conspiracy theories. Their spread on Twitter was consistent with spamming and coordinated efforts. These findings show the role of cross-platform sharing of YouTube videos over Twitter as a strategy to propagate primarily anti-vaccination messages. Future policies and interventions should consider how to counteract misinformation spread via such cross-platform activities.
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Affiliation(s)
- Tamar Ginossar
- Department of Communication and Journalism, Institute for Social Research, The University of New Mexico, Albuquerque, NM, USA
| | - Iain J. Cruickshank
- Institute for Software Research, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Elena Zheleva
- Computer Science Department, University of Illinois at Chicago, Chicago, IL, USA
| | - Jason Sulskis
- Computer Science Department, University of Illinois at Chicago, Chicago, IL, USA
| | - Tanya Berger-Wolf
- Translational Data Analytics Institute, Computer Science Engineering, Electrical, Computer Engineering, and Evolution, Ecology, and Organismal Biology, Ohio State University, Columbus, OH, USA
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Zhu J, Weng F, Zhuang M, Lu X, Tan X, Lin S, Zhang R. Revealing Public Opinion towards the COVID-19 Vaccine with Weibo Data in China: BertFDA-Based Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13248. [PMID: 36293828 PMCID: PMC9602858 DOI: 10.3390/ijerph192013248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 05/27/2023]
Abstract
The COVID-19 pandemic has created unprecedented burdens on people's health and subjective well-being. While countries around the world have established models to track and predict the affective states of COVID-19, identifying the topics of public discussion and sentiment evolution of the vaccine, particularly the differences in topics of concern between vaccine-support and vaccine-hesitant groups, remains scarce. Using social media data from the two years following the outbreak of COVID-19 (23 January 2020 to 23 January 2022), coupled with state-of-the-art natural language processing (NLP) techniques, we developed a public opinion analysis framework (BertFDA). First, using dynamic topic clustering on Weibo through the latent Dirichlet allocation (LDA) model, a total of 118 topics were generated in 24 months using 2,211,806 microblog posts. Second, by building an improved Bert pre-training model for sentiment classification, we provide evidence that public negative sentiment continued to decline in the early stages of COVID-19 vaccination. Third, by modeling and analyzing the microblog posts from the vaccine-support group and the vaccine-hesitant group, we discover that the vaccine-support group was more concerned about vaccine effectiveness and the reporting of news, reflecting greater group cohesion, whereas the vaccine-hesitant group was particularly concerned about the spread of coronavirus variants and vaccine side effects. Finally, we deployed different machine learning models to predict public opinion. Moreover, functional data analysis (FDA) is developed to build the functional sentiment curve, which can effectively capture the dynamic changes with the explicit function. This study can aid governments in developing effective interventions and education campaigns to boost vaccination rates.
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Affiliation(s)
- Jianping Zhu
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen 361005, China
- Data Mining Research Center, Xiamen University, Xiamen 361005, China
- School of Management, Xiamen University, Xiamen 361005, China
| | - Futian Weng
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen 361005, China
- Data Mining Research Center, Xiamen University, Xiamen 361005, China
- School of Medicine, Xiamen University, Xiamen 361005, China
| | - Muni Zhuang
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen 361005, China
- Data Mining Research Center, Xiamen University, Xiamen 361005, China
- School of Medicine, Xiamen University, Xiamen 361005, China
| | - Xin Lu
- College of Systems Engineering, National University of Defense Technology, Changsha 410073, China
| | - Xu Tan
- Career-Oriented Multidisciplinary Education Center, Shenzhen Institiute of Information Technology, Shenzhen 518172, China
| | - Songjie Lin
- Career-Oriented Multidisciplinary Education Center, Shenzhen Institiute of Information Technology, Shenzhen 518172, China
| | - Ruoyi Zhang
- Columbia College of Art and Science, George Washington University, Washington, DC 20052, USA
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Ng LHX, Cruickshank IJ, Carley KM. Cross-platform information spread during the January 6th capitol riots. SOCIAL NETWORK ANALYSIS AND MINING 2022; 12:133. [PMID: 36105923 PMCID: PMC9461432 DOI: 10.1007/s13278-022-00937-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 11/03/2022]
Abstract
Social media has become an integral component of the modern information system. An average person typically has multiple accounts across different platforms. At the same time, the rise of social media facilitates the spread of online mis/disinformation narratives within and across these platforms. In this study, we characterize the coordinated information dissemination of information laden with mis- and disinformation narratives within and across two platforms, Parler and Twitter, during the online discourse surrounding the January 6th 2021 Capitol Riots event. Through the use of username similarity, we discover joint theme endorsements between both platforms. Using anomalously high volume of shared-link matches of external websites and YouTube videos, we discover separate information consumption habits between both platforms, with very few common sources of information between users of the different platforms. However, through analyzing the similarity of the texts with Locality Sensitive Hashing of constructed text vectors, we identify similar narratives between the platforms despite separate consumption of external websites, highlighting the similarities and differences of information spread within and between the two social media environments.
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Affiliation(s)
- Lynnette Hui Xian Ng
- Center for Computational Analysis of Social and Organizational Systems, Carnegie Mellon University, 4665 Forbes Avenue, Pittsburgh, PA 15213 USA
| | - Iain J. Cruickshank
- Center for Computational Analysis of Social and Organizational Systems, Carnegie Mellon University, 4665 Forbes Avenue, Pittsburgh, PA 15213 USA
| | - Kathleen M. Carley
- Center for Computational Analysis of Social and Organizational Systems, Carnegie Mellon University, 4665 Forbes Avenue, Pittsburgh, PA 15213 USA
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Shaw NM, Hakam N, Lui J, Abbasi B, Sudhakar A, Leapman MS, Breyer BN. COVID-19 Misinformation and Social Network Crowdfunding: Cross-sectional Study of Alternative Treatments and Antivaccine Mandates. J Med Internet Res 2022; 24:e38395. [PMID: 35820053 PMCID: PMC9337619 DOI: 10.2196/38395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Crowdfunding is increasingly used to offset the financial burdens of illness and health care. In the era of the COVID-19 pandemic and associated infodemic, the role of crowdfunding to support controversial COVID-19 stances is unknown. OBJECTIVE We sought to examine COVID-19-related crowdfunding focusing on the funding of alternative treatments not endorsed by major medical entities, including campaigns with an explicit antivaccine, antimask, or antihealth care stances. METHODS We performed a cross-sectional analysis of GoFundMe campaigns for individuals requesting donations for COVID-19 relief. Campaigns were identified by key word and manual review to categorize campaigns into "Traditional treatments," "Alternative treatments," "Business-related," "Mandate," "First Response," and "General." For each campaign, we extracted basic narrative, engagement, and financial variables. Among those that were manually reviewed, the additional variables of "mandate type," "mandate stance," and presence of COVID-19 misinformation within the campaign narrative were also included. COVID-19 misinformation was defined as "false or misleading statements," where cited evidence could be provided to refute the claim. Descriptive statistics were used to characterize the study cohort. RESULTS A total of 30,368 campaigns met the criteria for final analysis. After manual review, we identified 53 campaigns (0.17%) seeking funding for alternative medical treatment for COVID-19, including popularized treatments such as ivermectin (n=14, 26%), hydroxychloroquine (n=6, 11%), and vitamin D (n=4, 7.5%). Moreover, 23 (43%) of the 53 campaigns seeking support for alternative treatments contained COVID-19 misinformation. There were 80 campaigns that opposed mandating masks or vaccination, 48 (60%) of which contained COVID-19 misinformation. Alternative treatment campaigns had a lower median amount raised (US $1135) compared to traditional (US $2828) treatments (P<.001) and a lower median percentile of target achieved (11.9% vs 31.1%; P=.003). Campaigns for alternative treatments raised substantially lower amounts (US $115,000 vs US $52,715,000, respectively) and lower proportions of fundraising goals (2.1% vs 12.5%) for alternative versus conventional campaigns. The median goal for campaigns was significantly higher (US $25,000 vs US $10,000) for campaigns opposing mask or vaccine mandates relative to those in support of upholding mandates (P=.04). Campaigns seeking funding to lift mandates on health care workers reached US $622 (0.15%) out of a US $410,000 goal. CONCLUSIONS A small minority of web-based crowdfunding campaigns for COVID-19 were directed at unproven COVID-19 treatments and support for campaigns aimed against masking or vaccine mandates. Approximately half (71/133, 53%) of these campaigns contained verifiably false or misleading information and had limited fundraising success. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1001/jamainternmed.2019.3330.
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Affiliation(s)
- Nathan M Shaw
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Nizar Hakam
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Jason Lui
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Behzad Abbasi
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Architha Sudhakar
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
| | - Michael S Leapman
- Department of Urology, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin N Breyer
- Department of Urology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
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Lattimer TA, Tenzek KE, Ophir Y, Sullivan SS. Exploring Online Twitter Conversations surrounding National Healthcare Decisions Day and Advance Care Planning from a Socio-Cultural Perspective: A Computational Mixed-Methods Analysis (Preprint). JMIR Form Res 2021; 6:e35795. [PMID: 35416783 PMCID: PMC9047726 DOI: 10.2196/35795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Within the cultures and societies of the United States, topics related to death and dying continue to be taboo, and as a result, opportunities for presence and engagement during the end of life, which could lead to a good death, are avoided. Several efforts have been made to help people engage in advance care planning (ACP) conversations, including completing advance care directives so that they may express their goals of care if they become too sick to communicate their wishes. A major effort in the United States toward encouraging such challenging discussions is the annual celebration of the National Healthcare Decisions Day. Objective This study aimed to explore ACP from a sociocultural perspective by using Twitter as a communication tool. Methods All publicly available tweets published between August 1, 2020, and July 30, 2021 (N=9713) were collected and analyzed using the computational mixed methods Analysis of Topic Model Network approach. Results The results revealed that conversations driven primarily by laypersons (7107/7410, 95.91% of tweets originated from unverified accounts) surrounded the following three major themes: importance and promotion, surrounding language, and systemic issues. Conclusions On the basis of the results, we argue that there is a need for awareness of the barriers that people may face when engaging in ACP conversations, including systemic barriers, literacy levels, misinformation, policies (including Medicare reimbursements), and trust among health care professionals, in the United States. This is incredibly important for clinicians and scholars worldwide to be aware of as we strive to re-envision ACP, so that people are more comfortable engaging in ACP conversations. In terms of the content of tweets, we argue that there is a chasm between the biomedical and biopsychosocial elements of ACP, including patient narratives. If used properly, Twitter conversations and National Health Care Decision Day hashtags could be harnessed to serve as a connecting point among organizations, physicians, patients, and family members to lay the groundwork for the trajectory toward a good death.
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Affiliation(s)
- Tahleen A Lattimer
- Department of Communication, University at Buffalo, SUNY, East Amherst, NY, United States
| | - Kelly E Tenzek
- Department of Communication, University at Buffalo, SUNY, East Amherst, NY, United States
| | - Yotam Ophir
- Department of Communication, University at Buffalo, SUNY, East Amherst, NY, United States
| | - Suzanne S Sullivan
- School of Nursing, University at Buffalo, SUNY, East Amherst, NY, United States
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