Community Mitigation of COVID-19 and Portrayal of Testing on TikTok: Descriptive Study

TikTok and teen mental health: an analysis of user-generated content and engagement

BACKGROUND

TikTok is a social media mobile application that is widely used by adolescents, and has the potential to serve as a revolutionary platform for public and mental health discourse, education, and intervention.

OBJECTIVE

Our study aimed to describe the content and engagement metrics of the hashtag #teenmentalhealth on TikTok.

METHODS

In this study, we: (a) conducted a directed content analysis of the Top 100 TikTok videos tagged with #teenmentalhealth, and (b) collected data on video engagements (views, likes, saves, and shares) and computed view-based engagement rates.

RESULTS

The videos collectively garnered 144,320,591 views; 28,289,655 likes; 219,780 comments; 1,971,492 saves; and 478,696 shares. Most of the generated content were from teens and therapists. Engagement metrics revealed strong user engagement rates across user types. The most prevalent content categories represented across videos were personal experience, coping techniques or treatment, humor, interpersonal relationships, and health campaign. The content categories with the highest engagement rates were relatable media representation, health campaign, social isolation, and humor. Only a single video incorporated evidence-based treatment content.

CONCLUSION

TikTok facilitates communication and information dissemination on teen mental health. Future research should focus on improving the quality and credibility of digital content while maintaining engagement through creativity, self-expression, and relatability. Use of popular social media platforms and community-engaged research to disseminate evidence-based content may help bridge the translational research gap.

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.

Sentiment Impact of Public Health Agency communication Strategies on TikTok under COVID-19 Normalization: Deep Learning Exploration

Aim

The accessibility of social media data has allowed researchers to measure official-public interactions during COVID-19. However, previous work analyzing official posts or public comments has failed to explore the link between the two. Therefore, this study investigates the relationship between the communication strategies of public health agencies (PHAs) on TikTok and public emotional/sentiment tendencies in COVID-19 normalization.

Subject and methods

This study uses the 2022 Shanghai city closure event as a public health communication case study in the context of COVID-19 normalization, using TikTok as a data source. We first analyze the communication strategies adopted by the PHA based on the Crisis and Emergency Risk Communication (CERC) model. Then, we classify the sentiment of public comments using the Large-Scale Knowledge Enhanced Pre-Training for Language Understanding and Generation (ERNIE) pre-training model. Finally, we explore the connection between PHA communication strategies and public sentiment tendencies.

Results

First, the public's sentiment tendencies differ at different stages. Therefore, appropriate communication strategies should be developed stage-by-stage. Second, the public's emotional disposition to different communication strategies varies: government statements, vaccines, and prevention and control programs are more likely to produce a friendly comment environment, while policy and new cases per day are more likely to produce unfavorable comment content. However, this does not mean that policy and new cases per day should be avoided; the judicious use of these two strategies can help PHAs understand the current issues causing public dissatisfaction. Third, videos with celebrity appearances can significantly increase positive public sentiment and, thereby, public participation.

Conclusion

We propose an improved CERC guideline for China based on the Shanghai lockdown case.

Tiktoking COVID-19 with frontline workers

Introduction/Objective

During the COVID-19 pandemic, frontline workers have taken to social media platforms to discuss a variety of issues that concern their personal and professional lives. In particular, TikTok's increased prominence as a social media channel has proved significant for enhancing the public presence of healthcare workers and their ability to disseminate content to a wider audience. The ways that healthcare workers use TikTok draws attention to the type of health information disseminated to the public through social media platforms. This provides the public with succinct and often visually entertaining information that may not be otherwise distributed to them directly from elsewhere. This study also provides relevant insights into how social media-TikTok in particular-can be used as a tool for disseminating knowledge about COVID-19 related topics and combatting misinformation by using the credibility of frontline workers.

Methods

This study collected a sample of over 2100 TikTok videos posted by healthcare workers that were coded according to the dominant overarching themes.

Results

The themes that arose from this sample were: (1) healthcare workers' mental health and working conditions, (2) healthcare heroes/appreciation, (3) criticism against official authorities, (4) countering misinformation, (5) humor/satire, and (6) educational content.

Conclusion

Due to the rise in public appreciation for frontline workers, examining the effects of the pandemic through the eyes of frontline workers has drawn attention to their lived realities in various forms. This study provided some insight into how frontline workers use TikTok to disseminate information and education to the public, often relying on their perceived credibility.

Communicating COVID-19 Risk on Instagram: A Content Analysis of Official Public Health Messaging During the First Year of the Pandemic

Early in the COVID-19 pandemic, social media platform Instagram surged in popularity as a source of health information. Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) leveraged Instagram accounts to publicly distribute COVID-related information. The current study investigated whether WHO and CDC messaging strategies on Instagram adhered to best practices defined by two theoretical frameworks: the extended parallel process model and crisis and emergency risk communication. We conducted a quantitative content analysis of COVID-related posts (n = 726) published between January-December 2020 to determine how both agencies (1) communicated the threat of the pandemic (e.g. susceptibility and severity of negative COVID-19 consequences); (2) appealed to self-, response, and collective efficacy; (3) incorporated cues to action (e.g. preventive behaviors, information seeking); and (4) leveraged credibility cues (e.g. scientific evidence, experts). Results showed threat information was limited, whereas efficacy appeals and cues to action were abundant. The CDC relied more heavily on depictions of self- and response efficacy, whereas the WHO appealed more frequently than the CDC to collective efficacy. Neither visually modeled behaviors nor leveraged scientific evidence or experts with great frequency. Implications for future research and official communication efforts via social media are discussed.

Creation, dissemination, and evaluation of videos to promote COVID-19 vaccination in India: A research protocol

Background: Vaccine hesitancy is one of the greatest challenges to the success of coronavirus disease 2019 (COVID-19) vaccination campaigns. Videos promoting vaccines have a narrow scope focusing solely on facts, and less on the emotional and narrative elements of communication that can be equally persuasive. The role of humor, for example, has remained largely unexplored.   Objective: This study investigates whether theory-based videos can change people's attitudes, beliefs, and intentions to receive the second COVID-19 vaccine. Our primary research question is: How do collectivistic and individualistic appeals, humor, and protagonist gender individually and jointly affect vaccination attitudes, beliefs, and intentions?   Methods: This project tapped into the underutilized Indian film industry-the world's largest film producer-to promote vaccination messaging through short videos. Feedback from a community advisory board was utilized to inform the video scripts that were then shot by a production team. Eight videos were filmed and shared by adopting a 2 (appeal: individualistic or collectivistic) x 2 (tone: humor or non-humor) x 2 (protagonist gender: male or female) between-subjects design approach. Our sample includes Odia-speaking participants aged between 18 - 35 years old randomly assigned to watch one of the eight study videos. An online survey questionnaire, social media network analysis, and small group qualitative interviews will be utilized to explore how the entertainment-education videos can be used to reduce vaccine hesitancy.  Discussion: Vaccine messages do not fall into a cultural or cognitive vacuum. People process and make sense of information based on their prior experience, properties of the message, and their social environment. Yet, these considerations have taken secondary importance in vaccine communications. This research shows that it is possible to deliver high-caliber videos created in accordance with the audience's cultural and cognitive background.   Conclusions: This study will inform future health promotion messaging through brief videos on the internet.

Deconstructing TikTok Videos on Mental Health: Cross-sectional, Descriptive Content Analysis

Background

Social media platforms that are based on the creation of visual media, such as TikTok, are increasingly popular with adolescents. Online social media networks provide valuable opportunities to connect with each other to share experiences and strategies for health and wellness.

Objective

The aim of this study was to describe the content of the hashtag #mentalhealth on TikTok.

Methods

This cross-sectional, descriptive content analysis study included 100 videos with the hashtag #mentalhealth on TikTok. All videos that included the hashtag #mentalhealth were analyzed and coded for the presence of content categories. Additionally, the comments to each video were viewed and coded for content in the following themes: offering support or validation; mentioning experience with suicide or suicidal ideation; mentioning experience with self-harm; describing an experience with hospitalization for mental health issues; describing other mental health issues; and sharing coping strategies, experiences of healing, or ways to feel better.

Results

Collectively, the 100 videos studied received 1,354,100,000 views; 266,900,000 likes; and 2,515,954 comments. On average, each video received 13,406,930.69 (SD 8,728,095.52) views; 2,657,425.74 (SD 1,449,920.45) likes; and 24,910.44 (SD 21,035.06) comments. The only content category observed in most (51/100, 51%) of the videos included in the sample was “general mental health.” The remaining content categories appeared in less than 50% of the sample. In total, 32% (32/100) of the videos sampled received more than the overall average number of likes (ie, more that 2.67 million likes). Among these 32 videos, 23 (72%) included comments offering support or validation and 20 (62%) included comments that described other mental health issues or struggles.

Conclusions

With over 1 billion cumulative views, almost half of the assessed TikTok videos included in this study reported or expressed symptoms of mental distress. Future research should focus on the potential role of intervention by health care professionals on social media.

Takotsubo syndrome on TikTok: An analysis of information quality and audience engagement (Preprint)

Background

The incidence of Takotsubo syndrome (TTS), also known as the broken heart syndrome or stress cardiomyopathy, is increasing worldwide. The understanding of its prognosis has been progressively evolving and currently appears to be poorer than previously thought, which has attracted the attention of researchers. An attempt to recognize the awareness of this condition among the general population drove us to analyze the dissemination of this topic on TikTok, a popular short-video–based social media platform. We found a considerable number of videos on TTS on TikTok; however, the quality of the presented information remains unknown.

Objective

The aim of this study was to analyze the quality and audience engagement of TTS-related videos on TikTok.

Methods

Videos on the TikTok platform were explored on August 2, 2021 to identify those related to TTS by using 6 Chinese keywords. A total of 2549 videos were found, of which 80 met our inclusion criteria and were evaluated for their characteristics, content, quality, and reliability. The quality and reliability were rated using the DISCERN instrument and the Journal of the American Medical Association (JAMA) criteria by 2 reviewers independently, and a score was assigned. Descriptive statistics were generated, and the Kruskal-Wallis test was used for statistical analysis. Multiple linear regression was performed to evaluate the association between audience engagement and other factors such as video content, video quality, and author types.

Results

The scores assigned to the selected video content were low with regard to the diagnosis (0.66/2) and management (0.34/2) of TTS. The evaluated videos were found to have an average score of 36.93 out of 80 on the DISCERN instrument and 1.51 out of 4 per the JAMA criteria. None of the evaluated videos met all the JAMA criteria. The quality of the relayed information varied by source (All P<.05). TTS-related videos made by health care professionals accounted for 28% (22/80) of all the evaluated videos and had the highest DISCERN scores with an average of 40.59 out of 80. Multiple linear regression analysis showed that author types that identified as health professionals (exponentiated regression coefficient 17.48, 95% CI 2.29-133.52; P=.006) and individual science communicators (exponentiated regression coefficient 13.38, 95% CI 1.83-97.88; P=.01) were significant and independent determinants of audience engagement (in terms of the number of likes). Other author types of videos, video content, and DISCERN document scores were not associated with higher likes.

Conclusions

We found that the quality of videos regarding TTS for patient education on TikTok is poor. Patients should be cautious about health-related information on TikTok. The formulation of a measure for video quality review is necessary, especially when the purpose of the published content is to educate and increase awareness on a health-related topic.

Social Media, Public Health, and Community Mitigation of COVID-19: Challenges, Risks, and Benefits

Shortly after the first case reports in 2019, COVID-19 was declared a pandemic. Early messages from trusted experts, which later proved to be inadequate or incorrect, highlight the need for continual adjustment of messages to the public as scientific knowledge evolves. During this time, social media exploded with greatly sought-after information, some of which was misinformation based on incomplete or incorrect facts or disinformation purposefully spread to advance a specific agenda. Because of the nature of social media, information, whether accurate or not at the time posted, lives on and remains accessible to the public even when its usefulness has been discredited. While the impact of mis/disinformation on COVID-19 risk-reducing behaviors is debatable, it is clear that social media has played a significant role in both extending the reach of COVID-19-related falsehoods and promoting evidence-based content. Over the last decade, social media has become a dominant source of information that consumers turn to for health information. A great deal of misinformation and disinformation has reached large numbers of social media users, which points to a need for the agencies of the US Public Health Service to create communications to convey accurate and current information and appeals that will actually be viewed. This viewpoint highlights the challenges, risks, and potential benefits that social media present in mitigating the COVID-19 pandemic.

A Content Analysis of YouTube Videos that Address Loss of Weight Gained During the COVID-19 Pandemic

Background

Many people experienced unintended weight gain during the COVID-19 pandemic, which has been discussed widely on social media.

Objective

This study aims to describe the content of weight loss videos on YouTube (Google LLC) during the COVID-19 pandemic.

Methods

By using the keywords weight loss during quarantine, the 100 most viewed English-language videos were identified and coded for content related to losing weight gained during the COVID-19 pandemic.

Results

In total, 9 videos were excluded due to having non-English content or posting data before the COVID-19 pandemic. The 91 videos included in the study sample acquired 407,326 views at the time of study and were roughly 14 minutes long. A total of 48% (44/91) of the sample videos included graphic comparisons to illustrate weight change. Videos that included a graphic comparison were more likely to have content related to trigger warnings (χ²₁=6.05; P=.01), weight loss (χ²₁=13.39; P<.001), negative feelings during quarantine (χ²₁=4.75; P=.03), instructions for losing weight (χ²₁=9.17; P=.002), self-love (χ²₁=6.01; P=.01), body shaming (χ²₁=4.36; P=.04), and special dietary practices (χ²₁=11.10; P<.001) but were less likely to include food recipes (χ²₁=5.05; P=.03). Our regression analysis results suggested that mentioning quarantine (P=.05), fat-gaining food (P=.04), self-care and self-love (P=.05), and body shaming (P=.008) and having presenters from both sexes (P<.001) are significant predictors for a higher number of views. Our adjusted regression model suggested that videos with content about routine change have significantly lower view counts (P=.03) than those of videos without such content.

Conclusions

The findings of this study indicate the ways in which YouTube is being used to showcase COVID-19–related weight loss in a pre-post fashion. The use of graphic comparisons garnered a great deal of attention. Additional studies are needed to understand the role of graphic comparisons in social media posts. Further studies that focus on people’s attitudes and behaviors toward weight change during the COVID-19 pandemic and the implications of social media on these attitudes and behaviors are warranted.