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Lindberg J, Lundgren AS. Peer-to-peer sharing in public health interventions: strategies when people share health-related personal information on social media. Int J Qual Stud Health Well-being 2024; 19:2367841. [PMID: 38920110 PMCID: PMC11210409 DOI: 10.1080/17482631.2024.2367841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE As sharing on social media has become an integrated part of everyday life, health and public health actors have started to show interest in the potential of people's peer-to-peer sharing of health-related personal information (HRI) for health interventions. In this article we focus on how people make sense of sharing HRI on social media. METHODS Twenty-two people between the ages 40 and 60 who had taken part in a regional health intervention were interviewed. Using theories about social media sharing, we explore their understandings and negotiations about whether, how much, and how to share HRI and discuss the results in relation to peer-to-peer sharing as a strategy in interventions. RESULTS We identified three aspects that were perceived as particularly risky: loss of control, effects on identity, and affecting others negatively, along with strategies that were used to manage risks in practice: avoiding sharing, allocating, and embedding HRI. CONCLUSIONS By allocating and embedding HRI, people can unlock motivating affordances for health work. However, strategies to manage risks can also be counterproductive. For actors to provide equality in health promotion, initiatives that include social media sharing need to be mindful of the sometimes counterproductive effects this may have on people's engagement.
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Affiliation(s)
- Jens Lindberg
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Anna Sofia Lundgren
- Department of Culture and Media Studies, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
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Adebola A, Charis E, Tristan N, Melinda I. Content validation of a Facebook HPV vaccination promotion intervention (#HPVvaxtalks) created for young Black adults (18-26 years old). Public Health Nurs 2024. [PMID: 38923608 DOI: 10.1111/phn.13356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 04/12/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Despite the expansion in human papillomavirus (HPV) vaccination recommendations, vaccine uptake and completion remain low among Black individuals. An 8-week Facebook intervention (#HPVvaxtalks) was developed to increase knowledge and awareness of HPV risk factors, risk perceptions, and vaccination intention and uptake. This article details the formative phase of experts' feedback and participants' satisfaction on the components of the #HPVvaxtalks for content useability, acceptability, relevance, and visual appeal to inform further refinements. METHOD A convenience sample of 5 experts and 13 young Black adults were invited to provide feedback on #HPVvaxtalks intervention content. The experts reviewed and provided feedback via a survey and open-ended questions. After incorporating suggestions from experts' feedback, 13 participants viewed #HPVvaxtalks posts, took part in a virtual focus group, and completed a survey. Qualitative data were thematically analyzed and integrated with survey results. RESULTS Experts and participants mean age were 41.9 ± 2.3 and 21.2 ± 1.9 years, respectively. Experts and participants reported positive ratings for intervention posts, including useability, acceptability, relevance, and visual appeal. Data provided areas for improvements of #HPVvaxtalks. CONCLUSION: Experts indicated strong content validity and participants showed satisfaction with #HPVvaxtalks content. Ensuring acceptability, relevance, and appeal of the intervention for the target population is an integral part of intervention development.
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Affiliation(s)
- Adegboyega Adebola
- Department of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Ebikwo Charis
- Department of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Ntego Tristan
- Department of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Ickes Melinda
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, Kentucky, USA
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Simmering JE, Polgreen LA, Francis SL, Strom AJ, Segre AM, Polgreen PM. Using a Fitbit-based Walking Game to Improve Physical Activity Among U.S. Veterans. Mil Med 2024:usae280. [PMID: 38829720 DOI: 10.1093/milmed/usae280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/11/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Physical inactivity, hereafter inactivity, is a serious health problem among U.S. veterans, hereafter veterans. Inactive adults are at risk for adverse cardiac events and premature mortality. Specifically, among veterans, inactivity has been associated with a 23% increase in mortality. In order to increase physical activity among veterans, we developed Veterans Affairs (VA) MapTrek, a mobile-phone-based web app that allows users to take a virtual walk in interesting locations around the world while tracking their progress against that of others like themselves on an interactive map. Steps are counted by a commercially available Fitbit triaxial accelerometer, and users see their progress along a predefined scenic path overlaid on Google Maps. The objective of this study was to determine the effectiveness of VA MapTrek to increase physical activity in a population of veterans at risk for obesity-related morbidity. MATERIALS AND METHODS We recruited overweight and obese veterans obtaining care at the Iowa City Veterans Affairs Health Center. Half of the veterans were assigned to participate in VA MapTrek. Each week, participants were assigned virtual walking races (Monday through Saturday), which followed a predetermined route that is displayed on Google Maps. The participant's position on the map is automatically updated each time their Fitbit syncs to their phone. In addition, challenges were issued periodically. Veterans in the control group were only given a Fitbit. We regressed daily step counts on the days of the week, the days since the start of the intervention period, whether the user was in the VA MapTrek or Control group, and an interaction between the study group and the days since the start of the intervention period. We included subject-specific random intercepts and subject-specific random slopes. This model was estimated using Bayesian Hamiltonian Monte Carlo using Stan's No-U-Turns sampler. We set vague, uniform priors on all the parameters. RESULTS We enrolled 276 participants, but only 251 (102 in the control group and 149 in the VA MapTrek group) contributed data during the intervention period. Our analysis suggests an 86.8% likelihood that the VA MapTrek intervention led to a minimum increase of 1,000 daily steps over the 8-week period, compared to the control group. Throughout the 8-week intervention, we project that VA MapTrek participants would have taken an extra 96,627 steps, equivalent to 77.8 additional kilometers (km) (48.3 additional miles), assuming an average of 1,242 steps per km (2,000 steps per mile). CONCLUSIONS Our study underscores the potential of VA MapTrek as an intervention for promoting walking among veterans who face elevated risks of obesity and cardiac issues. Rural veterans are a high-risk population, and new interventions like VA MapTrek are needed to improve veterans' health.
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Affiliation(s)
- Jacob E Simmering
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Office of Rural Health, Veterans Rural Health Resource Center, Iowa City Veterans Affairs Health Care System, Iowa City, IA 52246, USA
| | - Linnea A Polgreen
- Department of Pharmacy Practice and Science, University of Iowa, Iowa City, IA 52242, USA
| | - Shelby L Francis
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Office of Rural Health, Veterans Rural Health Resource Center, Iowa City Veterans Affairs Health Care System, Iowa City, IA 52246, USA
| | - Austin J Strom
- Department of Computer Science, University of Iowa, Iowa City, IA 52242, USA
| | - Alberto M Segre
- Office of Rural Health, Veterans Rural Health Resource Center, Iowa City Veterans Affairs Health Care System, Iowa City, IA 52246, USA
- Department of Computer Science, University of Iowa, Iowa City, IA 52242, USA
| | - Philip M Polgreen
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Office of Rural Health, Veterans Rural Health Resource Center, Iowa City Veterans Affairs Health Care System, Iowa City, IA 52246, USA
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Nath S, Bhattacharya S, Golla VB, Kumar R. Effect of Social Media on Diet, Lifestyle, and Performance of Athletes: A Review of Current Evidence. Curr Nutr Rep 2024; 13:240-250. [PMID: 38460051 DOI: 10.1007/s13668-024-00526-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE OF REVIEW Social media (SM) plays an important role in providing diet and health advice to athletes, but it also carries with it a risk of credibility in the information sought for and received. The objective of this review is to assess the knowledge gap on how SM influences dietary and lifestyle practices in athletes. RECENT FINDINGS For this, relevant literature was searched in three leading databases with appropriate keywords, which were subjected to proper scrutiny that led to inclusion of 22 articles (original research papers, reviews, viewpoints, and commentaries). The current era of digitalization has seen an over-reliance on internet and SM for nutrition and lifestyle advice for an athlete. SM has become a powerful tool in athlete's choice of food, nutrition information, healthy living, and performance, with merits and demerits. Their role in choosing dietary supplements and particular food types (e.g., ketogenic diet), body image, self-esteem and eating disorders, and in lifestyle and performance are discussed. SM should be used with caution and should not be used alone as a source of information for nutrition related pieces of advise by athletes. Any food type and supplements trending in SM should be discussed with a sports nutritionist before consumption. SM influencers having a big follower base may not always be disseminating the right knowledge on food and nutrition, thus caution should be exercised. For optimal benefit to the athlete, SM information should be in alignment with recommendations provided by sports nutrition and coaches.
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Affiliation(s)
- Santanu Nath
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, 814152, Jharkhand, India.
| | | | - Vani Bhushanam Golla
- Department of Sports Nutrition, National Center for Sports, Science and Research, Sports Authority of India, Patiala, Punjab, India
| | - Rajesh Kumar
- Department of General Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Braga BC, Nguyen PH, Tran LM, Hoang NT, Bannerman B, Doyle F, Folson G, Gangupantulu R, Karachiwalla N, Kolt B, McCloskey P, Palloni G, Thi Tran TH, Thuy Thi Trơưng D, Hughes D, Gelli A. Feasibility of Using an Artificial Intelligence-based Telephone Application for Dietary Assessment and Nudging to Improve the Quality of Food Choices of Female Adolescents in Vietnam: Evidence from a Randomized Pilot Study. Curr Dev Nutr 2024; 8:102063. [PMID: 38817706 PMCID: PMC11137395 DOI: 10.1016/j.cdnut.2023.102063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 06/01/2024] Open
Abstract
Background Adolescent nutrition has faced a policy neglect, partly owing to the gaps in dietary intake data for this age group. The Food Recognition Assistance and Nudging Insights (FRANI) is a smartphone application validated for dietary assessment and to influence users toward healthy food choices. Objectives This study aimed to assess the feasibility (adherence, acceptability, and usability) of FRANI and its effects on food choices and diet quality in female adolescents in Vietnam. Methods Adolescents (N = 36) were randomly selected from a public school and allocated into 2 groups. The control group received smartphones with a version of FRANI limited to dietary assessment, whereas the intervention received smartphones with gamified FRANI. After the first 4 wk, both groups used gamified FRANI for further 2 wk. The primary outcome was the feasibility of using FRANI as measured by adherence (the proportion of completed food records), acceptability and usability (the proportion of participants who considered FRANI acceptable and usable according to answers of a Likert questionnaire). Secondary outcomes included the percentage of meals recorded, the Minimum Dietary Diversity for Women (MDDW) and the Eat-Lancet Diet Score (ELDS). Dietary diversity is important for dietary quality, and sustainable healthy diets are important to reduce carbon emissions. Poisson regression models were used to estimate the effect of gamified FRANI on the MDDW and ELDS. Results Adherence to the application was 82% and the percentage of meals recorded was 97%. Acceptability and usability were 97%. MDDW in the intervention group was 1.07 points (95% CI: 0.98, 1.18; P = 0.13) greater than that in the control (constant = 4.68); however, the difference was not statistically significant. Moreover, ELDS in the intervention was 1.09 (95% CI: 1.01, 1.18; P = 0.03) points greater than in the control (constant = 3.67). Conclusions FRANI was feasible and may be effective to influence users toward healthy food choices. Research is needed for FRANI in different contexts and at scale.The trial was registered at the International Standard Randomized Controlled Trial Number as ISRCTN 10681553.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Boston, MA, United States
| | - Phuong H Nguyen
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Lan Mai Tran
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Boateng Bannerman
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Frank Doyle
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Gloria Folson
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Rohit Gangupantulu
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Naureen Karachiwalla
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Bastien Kolt
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Peter McCloskey
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Giordano Palloni
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | | | | | - David Hughes
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Aulo Gelli
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
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Peng L, Wang J. Algorithm as Recommending Source and Persuasive Health Communication: Effects of Source Cues, Language Intensity, and Perceived Issue Involvement. HEALTH COMMUNICATION 2024; 39:852-861. [PMID: 37525527 DOI: 10.1080/10410236.2023.2242087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Algorithms are now playing significant roles in online health information selection and recommendation. A question arises as to when and why people would be persuaded by the content they recommend. We conducted a 4 (recommending source: algorithm, other users, a friend, the CDC) x 2 (language intensity: high vs. low) experiment to find out. Participants (N = 299) were exposed to a health-related public service announcement embedded in a social media post. The results showed that overall, an algorithm induced a similar level of compliance intention compared with other recommending sources. We also found a significant three-way interaction when comparing the effects of the algorithm and the CDC: for individuals with low issue involvement, the algorithm was less persuasive when paired with a message with high language intensity. In contrast, for high-involvement individuals, the algorithm elicited more fear than the CDC when recommending an assertive message, partially leading to more compliance intention.
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Affiliation(s)
- Lulu Peng
- School of Journalism and Information Communication, Huazhong University of Science and Technology
| | - Jinping Wang
- College of Journalism and Communications, University of Florida
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Gill N, Banta JE, Gashugi L, Young SD. Analysis of Participant Stigma and Associated Costs of a Peer-Led Social Media HIV Intervention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024; 36:113-128. [PMID: 38648178 DOI: 10.1521/aeap.2024.36.2.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
HIV-related stigma is a primary barrier to seeking HIV care. Online social media interventions utilizing peer-led approaches provide an opportunity to revolutionize HIV health behavior change. Secondary analysis of the UCLA HOPE Study (6 waves) was done to examine the effectiveness of an online peer-led intervention in reducing HIV-related internalized stigma (IS), association between IS and sexual risk behaviors (SRB), and associated costs for changing the likelihood of HIV testing. Among 897 participants, an inverse relationship between IS (Discomfort with people with HIV, Stereotypes, Moral Judgment) and SRB (Number of Sexual Partners, Sexual Encounters) factors was identified over time (p < .05). Engagement in stigma conversations increased participant likelihood to request HIV tests (B = 0.02, Wald = 8.10, p = .004) when made in group versus one-on-one contact. Innovative technology has potential to improve HIV-care efforts through expanded reach to at-risk populations, improved communication maintenance, ease of accessibility, and user anonymity.
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Affiliation(s)
- Navkiranjit Gill
- School of Public Health, Loma Linda University, Loma Linda, California
| | - Jim E Banta
- School of Public Health, Loma Linda University, Loma Linda, California
| | - Leonard Gashugi
- School of Public Health, Loma Linda University, Loma Linda, California
| | - Sean D Young
- Department of Emergency Medicine and with the Department of Informatics, University of California, Irvine, Irvine, California
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Haime Z, Kennedy L, Grace L, Cohen R, Derges J, Biddle L. The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study. JMIR INFODEMIOLOGY 2024; 4:e47699. [PMID: 38546718 PMCID: PMC11009851 DOI: 10.2196/47699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 10/10/2023] [Accepted: 02/15/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content. OBJECTIVE This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period. METHODS This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data. RESULTS The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms. CONCLUSIONS This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.
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Affiliation(s)
- Zoë Haime
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laura Kennedy
- Centre for Society and Mental Health, Kings College, London, United Kingdom
- Samaritans, Surrey, United Kingdom
- Department of Health Service and Population Research, King's College London, London, United Kingdom
| | | | - Rachel Cohen
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Health and Social Services Group, Welsh Government, Cardiff, United Kingdom
| | - Jane Derges
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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McKenzie AH, Friedman BG, Carpentier FRD, Lazard AJ, Salazar LF, Shegog R. Recognize & Resist: An Online Health Intervention to Promote Writing About Sexual Consent and Egalitarian Gender Roles Among One Direction Fanfiction Writers. HEALTH COMMUNICATION 2024; 39:529-540. [PMID: 36734475 PMCID: PMC10397359 DOI: 10.1080/10410236.2023.2171950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This paper focuses on the development and feasibility of a digitally-based educational intervention, titled Recognize & Resist (R&R), for writers of One Direction (1D) fanfiction on Wattpad.com. The goal of R&R is to reduce the prevalence of social norms that are supportive of sexual violence within 1D fanfiction. 1D fanfictions, or fictional romance stories written by fans of this British boy band, have hundreds of millions of views on Wattpad.com. Formative research has found that social norms supportive of sexual violence are prevalent in 1D fanfictions and that some authors have internalized these norms. R&R aims to motivate 1D fanfiction writers to highlight sexual consent and egalitarian gender roles in their writing. To evaluate the intervention's feasibility, 15 1D fanfiction authors completed a survey and participated in an interview or focus group. Results demonstrate R&R's feasibility, with high ratings of its acceptability and demand. Insights from the interviews and focus groups provide suggestions for revising R&R before rigorously evaluating its efficacy. Additionally, results demonstrate the utility of using popular culture as a vehicle for attitude-change regarding sensitive health issues.
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Affiliation(s)
| | - Barbara G. Friedman
- University of North Carolina at Chapel Hill, Hussman School of Journalism and Media
| | | | - Allison J. Lazard
- University of North Carolina at Chapel Hill, Hussman School of Journalism and Media
- University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center
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De Las Heras-Alonso A, Seoane-Mato D, Guerra M, Macía-Villa C. Evaluating the impact of the website campaign "A ti también te puede tocar" ("It could also be you") to spread awareness of systemic autoimmune rheumatic diseases. REUMATOLOGIA CLINICA 2024; 20:171-172. [PMID: 38494308 DOI: 10.1016/j.reumae.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/07/2023] [Indexed: 03/19/2024]
Affiliation(s)
- Ana De Las Heras-Alonso
- Communication and Patients Relations Department, Spanish Society of Rheumatology, Madrid, Spain.
| | | | - Mercedes Guerra
- Research Unit, Spanish Society of Rheumatology, Madrid, Spain
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Huynh E, Swait J, Lancsar E, Ride J. Menu choice stated preference tasks to capture demand complementarity in health. Soc Sci Med 2024; 344:116636. [PMID: 38394862 DOI: 10.1016/j.socscimed.2024.116636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/24/2023] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Health programs/services are often bundled, allowing for both substitution and complementarity. We adapt Discrete Choice Experiments to capture bundling, with application to a case study of exercise and nutrition; complementarity arises due to the goal of improving health. Our contributions are (1) to present a menu-based choice experiment to explore bundling; (2) to analyse the menu-based data using an extension of the choice set generation model (GenL) to account for correlations between bundles and component singles. A nationally representative sample of 333 Australians chose between a nutrition program only; exercise program only; both nutrition and exercise programs; or their status quo. Overall, we show that by incorporating the menu choice task and introducing the combined alternative, we capture a significant portion of the population seeking both exercise and nutrition components. We estimate a latent class GenL model, and identify two latent classes: Class 1 preferred to choose programs on offer, and Class 2 was more price sensitive and had a stronger preference for staying with their status quo. We show in the post-estimation analysis that heterogeneity in preferences translates into heterogeneity in the way alternatives are bundled, indicating that the combined offering is appealing to specific classes of individuals who prefer bundling. By implementing the menu choice task, researchers and policymakers can effectively identify, cater to and influence the demand for combined exercise and nutrition options, leading to more targeted and impactful interventions in promoting healthier lifestyle choices.
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Affiliation(s)
- Elisabeth Huynh
- Department of Health Economics, Wellbeing and Society, National Centre for Epidemiology and Population Health, Australian National University, 63A Eggleston Road, Acton, ACT, 2601, Australia.
| | - Joffre Swait
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands.
| | - Emily Lancsar
- Department of Health Economics, Wellbeing and Society, National Centre for Epidemiology and Population Health, Australian National University, 63A Eggleston Road, Acton, ACT, 2601, Australia.
| | - Jemimah Ride
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia.
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Borg DJ, Haritopoulou-Sinanidou M, Gabrovska P, Tseng HW, Honeyman D, Schweitzer D, Rae KM. Barriers and facilitators for recruiting and retaining male participants into longitudinal health research: a systematic review. BMC Med Res Methodol 2024; 24:46. [PMID: 38389065 PMCID: PMC10882922 DOI: 10.1186/s12874-024-02163-z] [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: 08/10/2023] [Accepted: 01/28/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Successfully recruiting male participants to complete a healthcare related study is important for healthcare study completion and to advance our clinical knowledgebase. To date, most research studies have examined the barriers and facilitators of female participants in longitudinal healthcare-related studies with limited information available about the needs of males in longitudinal research. This systematic review examines the unique barriers and facilitators to male recruitment across longitudinal healthcare-related research studies. METHODS Following PRIMSA guidelines, MEDLINE, Embase, CINAHL and Web of Science databases were systematically searched using the terms recruitment and/or retention, facilitators and/or barriers and longitudinal studies from 1900 to 2023 which contained separate data on males aged 17-59 years. Health studies or interventions were defined longitudinal if they were greater than or equal to 12 weeks in duration with 3 separate data collection visits. RESULTS Twenty-four articles published from 1976-2023 met the criteria. One-third of the studies had a predominantly male sample and four studies recruited only male participants. Males appear disinterested towards participation in health research, however this lack of enthusiasm can be overcome by clear, non-directive communication, and studies that support the participants interests. Facilitating factors are diverse and may require substantial time from research teams. CONCLUSIONS Future research should focus on the specific impact of these factors across the spectrum of longitudinal health-related studies. Based on the findings of this systematic review, researchers from longitudinal health-related clinical trials are encouraged to consider male-specific recruitment strategies to ensure successful recruitment and retention in their studies. REGISTRATION This systemic review is registered with the PROSPERO database (CRD42021254696).
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Affiliation(s)
- Danielle J Borg
- Pregnancy and Development Group, Mater Research - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia
| | | | - Pam Gabrovska
- Indigenous Health Group, Mater Research Institute - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia
| | - Hsu-Wen Tseng
- Stem Cell Biology Group, Mater Research Institute - The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - David Honeyman
- Library, University of Queensland, St Lucia, 4072, Australia
| | - Daniel Schweitzer
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia
- Department of Neurology, Mater Health, South Brisbane, 4101, Australia
| | - Kym M Rae
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia.
- Indigenous Health Group, Mater Research Institute - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia.
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Kostygina G, Kim Y, Gebhardt Z, Tran H, Norris A, Page S, Borowiecki M, Rose SW, Emery S. Using Exogenous Social Media Exposure Measures to Assess the Effects of Smokeless Tobacco-Related Social Media Content on Smokeless Tobacco Sales in the United States. Nicotine Tob Res 2024; 26:S49-S56. [PMID: 38366341 PMCID: PMC10873503 DOI: 10.1093/ntr/ntad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/20/2023] [Accepted: 09/06/2023] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Prior research on the effects of social media promotion of tobacco products has predominantly relied on survey-based self-report measures of marketing exposure, which potentially introduce endogeneity, recall, and selection biases. New approaches can enhance measurement and help better understand the effects of exposure to tobacco-related messages in a dynamic social media marketing environment. We used geolocation-specific tweet rate as an exogenous indicator of exposure to smokeless tobacco (ST)-related content and employed this measure to examine the influence of social media marketing on ST sales. AIMS AND METHODS Autoregressive error models were used to analyze the association between the ST-relevant tweet rate (aggregated by 4-week period from February 12, 2017 to June 26, 2021 and scaled by population density) and logarithmic ST unit sales across time by product type (newer, snus, conventional) in the United States, accounting for autocorrelated errors. Interrupted time series approach was used to control for policy change effects. RESULTS ST product category-related tweet rates were associated with ST unit sales of newer and conventional products, controlling for price, relevant policy events, and the coronavirus disease 2019 (COVID-19) pandemic. On average, 100-unit increase in the number of newer ST-related tweets was associated with 14% increase in unit sales (RR = 1.14; p = .01); 100-unit increase in conventional ST tweets was associated with ~1% increase in unit sales (p = .04). Average price was negatively associated with the unit sales. CONCLUSIONS Study findings reveal that ST social media tweet rate was related to increased ST consumption and illustrate the utility of exogenous measures in conceptualizing and assessing effects in the complex media environment. IMPLICATIONS Tobacco control initiatives should include efforts to monitor the role of social media in promoting tobacco use. Surveillance of social media platforms is critical to monitor emerging tobacco product-related marketing strategies and promotional content reach. Exogenous measures of potential exposure to social media messages can supplement survey data to study media effects on tobacco consumption.
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Affiliation(s)
- Ganna Kostygina
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Yoonsang Kim
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Zachary Gebhardt
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Hy Tran
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Andrew Norris
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Simon Page
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Mateusz Borowiecki
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
| | - Shyanika W Rose
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Sherry Emery
- Social Data Collaboratory, NORC at the University of Chicago, Chicago, IL, USA
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Bravo CA, Walker MJ, Papadopoulos A, McWhirter JE. Social media use in HPV-, cervical cancer-, and cervical screening-related research: A scoping review. Prev Med 2024; 179:107798. [PMID: 38065338 DOI: 10.1016/j.ypmed.2023.107798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/20/2023] [Accepted: 12/03/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE In response to the World Health Organization's global call to eliminate cervical cancer, many countries have targets to implement human papillomavirus (HPV) primary screening. Social media may offer opportunities to promote uptake of HPV screening. We aimed to describe the extent of the scientific literature regarding social media research on HPV, cervical cancer and cervical screening. METHODS Seven databases were searched for peer-reviewed English-language studies related to social media research and HPV, cervical cancer and cervical screening published up to November 2023. One reviewer completed the title/abstract screening and two reviewers independently reviewed full-text articles. Data extraction was carried out by one reviewer and verified by a second reviewer. Information such as the research topic, social media platform of interest, participant characteristics, methods, analysis type, outcome measures, and key findings were collected. RESULTS In the 58 articles included, researchers used social media in the following ways: evaluate content, recruit participants or disseminate a survey/questionnaire, disseminate health communication content, examine the relationship between social media use and outcomes, and to conduct experiments testing the effects of social media content on outcomes. Twitter and Facebook were the most common platforms mentioned. Four articles explicitly mentioned theory. CONCLUSIONS Opportunities for research are identified such as further exploration of how newer social media platforms such as Instagram and TikTok can be used to share HPV content, examination of appropriate images for effective communication, and determining key features of social media content to promote information sharing and improve cervical screening knowledge, attitudes and behaviours.
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Affiliation(s)
- Caroline A Bravo
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Meghan J Walker
- Ontario Health (Cancer Care Ontario), Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Bezzina A, Clarke ED, Ashton L, Watson T, James CL. Workplace Health Promotion Programs Targeting Smoking, Nutrition, Physical Activity, and Obesity in Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. HEALTH EDUCATION & BEHAVIOR 2024; 51:113-127. [PMID: 38009189 PMCID: PMC10785566 DOI: 10.1177/10901981231208396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m2 up to 3 months; -0.27 kg/m2 for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > .05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.
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Affiliation(s)
- Aaron Bezzina
- Centre for Resources Health and Safety, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, 2308, Australia
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, 2308, Australia
| | - Erin D. Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, 2308, Australia
- Food and Nutrition Program, HMRI, Lot 1 Kookaburra, New Lambton Heights, NSW 2305, Australia
| | - Lee Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, 2308, Australia
| | - Trent Watson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, 2308, Australia
- Ethos Health, Newcastle West, 2302, Australia
| | - Carole L. James
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown NSW, 2006, Australia
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Wippold GM, Garcia KA, Frary SG, Griffith DM. Community Health Worker Interventions for Men: A Scoping Review Using the RE-AIM Framework. HEALTH EDUCATION & BEHAVIOR 2024; 51:128-143. [PMID: 37350223 DOI: 10.1177/10901981231179498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Community health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community's needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts. METHODS The protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria. RESULTS Most interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised. DISCUSSION CHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions.
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Buja A, Lo Bue R, Mariotti F, Miatton A, Zampieri C, Leone G. Promotion of Physical Activity Among University Students With Social Media Or Text Messaging: A Systematic Review. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241248131. [PMID: 38742671 PMCID: PMC11095173 DOI: 10.1177/00469580241248131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 05/16/2024]
Abstract
Regular physical exercise lowers the risk of all-cause mortality and various chronic diseases. New technologies, such as smartphones and social media, have been used successfully as health promotion tools in college populations. The purpose of this study was to conduct a systematic review of studies examining the effectiveness of interventions that used modern technologies, as with social media or text messaging, to promote physical activity or reducing sedentary behavior in college students. The systematic review was conducted on the PubMed and SCOPUS databases, considering studies published from 2012 to 2022. For a total of 19 articles selected, an evidence table was drawn up, and the quality of the studies was assessed using the PRISMA checklist. The interventions differed enormously in design, from the strategies implemented to the types of outcome considered. Fifteen of the 19 studies demonstrated an improvement in participants' physical activity levels, 3 studies found no such improvement, and 1 reported a worsening of baseline activity levels. Interventions to improve college students' physical activity levels through the use of social media and/or text messaging tend to be effective. However, many factors can influence the effectiveness of such interventions. For example, a gender-related difference emerged in student participation, and the interventions proved more effective if they were accompanied by the creation of social groups.
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Affiliation(s)
- Alessandra Buja
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Roberta Lo Bue
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Federico Mariotti
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Andrea Miatton
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Chiara Zampieri
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Giovanni Leone
- Department of Cardiological, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
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Valen EN, Øverby NC, Hardy‐Johnson P, Vik FN, Salvesen L, Omholt ML, Barker ME, Hillesund ER. Lessons learned from talking with adults about nutrition: A qualitative study in the PREPARED project. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 2:e13540. [PMID: 37277971 PMCID: PMC10765357 DOI: 10.1111/mcn.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
Improving diet and dietary behaviour of men and women before pregnancy has the potential to benefit both their current and long-term health and the health of their children. Little is known, however, about adults' perception of diet's role in prepregnancy health. This study aimed to explore the state of knowledge and awareness of preconception nutritional health in adults within the fertile age range and what they perceived could motivate healthy eating using the self-determination theory as a theoretical framework. We analysed 33 short exploratory interviews with men (n = 18) and women (n = 15) aged 18-45 years. Participants were grab sampled from three different public locations in the southern part of Norway. Interviews were audio-recorded, transcribed verbatim in 2020 and analysed using a thematic analysis with a semantic approach in 2022. The findings suggest that adults within the fertile age range are not intrinsically motivated to eat healthily, but when they do, it is because eating healthily often aligns with other goals consistent with their values, that is, getting fit or looking good. They possess some basic knowledge of healthy behaviours during pregnancy but are generally unaware of the importance of preconception health and nutrition. There is a need to increase awareness of the impact of preconception health on the health of this and future generations. Improved nutritional education on the significance of diet before conception might facilitate optimal conditions for conceiving and for pregnancy in the adult population within fertile age range.
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Affiliation(s)
- Erlend N. Valen
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Polly Hardy‐Johnson
- Medical Research Council Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Frøydis N. Vik
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Lorentz Salvesen
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Mona L. Omholt
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Mary Elizabeth Barker
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
- Medical Research Council Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Elisabet R. Hillesund
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
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Grady A, Pearson N, Lamont H, Leigh L, Wolfenden L, Barnes C, Wyse R, Finch M, Mclaughlin M, Delaney T, Sutherland R, Hodder R, Yoong SL. The Effectiveness of Strategies to Improve User Engagement With Digital Health Interventions Targeting Nutrition, Physical Activity, and Overweight and Obesity: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e47987. [PMID: 38113062 PMCID: PMC10762625 DOI: 10.2196/47987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Digital health interventions (DHIs) are effective in improving poor nutrition, physical inactivity, overweight and obesity. There is evidence suggesting that the impact of DHIs may be enhanced by improving user engagement. However, little is known about the overall effectiveness of strategies on engagement with DHIs. OBJECTIVE This study aims to assess the overall effectiveness of strategies to improve engagement with DHIs targeting nutrition, physical activity, and overweight or obesity and explore associations between strategies and engagement outcomes. The secondary aim was to explore the impact of these strategies on health risk outcomes. METHODS The MEDLINE, Embase, PsycINFO, CINAHL, CENTRAL, Scopus, and Academic Source Complete databases were searched up to July 24, 2023. Eligible studies were randomized controlled trials that evaluated strategies to improve engagement with DHIs and reported on outcomes related to DHI engagement (use or user experience). Strategies were classified according to behavior change techniques (BCTs) and design features (eg, supplementary emails). Multiple-variable meta-analyses of the primary outcomes (usage and user experience) were undertaken to assess the overall effectiveness of strategies. Meta-regressions were conducted to assess associations between strategies and use and user experience outcomes. Synthesis of secondary outcomes followed the "Synthesis Without Meta-Analysis" guidelines. The methodological quality and evidence was assessed using the Cochrane risk-of-bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation tool respectively. RESULTS Overall, 54 studies (across 62 publications) were included. Pooled analysis found very low-certainty evidence of a small-to-moderate positive effect of the use of strategies to improve DHI use (standardized mean difference=0.33, 95% CI 0.20-0.46; P<.001) and very low-certainty evidence of a small-to-moderate positive effect on user experience (standardized mean difference=0.29, 95% CI 0.07-0.52; P=.01). A significant positive association was found between the BCTs social support (effect size [ES]=0.40, 95% CI 0.14-0.66; P<.001) and shaping knowledge (ES=0.39, 95% CI 0.03-0.74; P=.03) and DHI use. A significant positive association was found among the BCTs social support (ES=0.70, 95% CI 0.18-1.22; P=.01), repetition and substitution (ES=0.29, 95% CI 0.05-0.53; P=.03), and natural consequences (ES=0.29, 95% CI 0.05-0.53; P=.02); the design features email (ES=0.29, 95% CI 0.05-0.53; P=.02) and SMS text messages (ES=0.34, 95% CI 0.11-0.57; P=.01); and DHI user experience. For secondary outcomes, 47% (7/15) of nutrition-related, 73% (24/33) of physical activity-related, and 41% (14/34) of overweight- and obesity-related outcomes reported an improvement in health outcomes. CONCLUSIONS Although findings suggest that the use of strategies may improve engagement with DHIs targeting such health outcomes, the true effect is unknown because of the low quality of evidence. Future research exploring whether specific forms of social support, repetition and substitution, natural consequences, emails, and SMS text messages have a greater impact on DHI engagement is warranted. TRIAL REGISTRATION PROSPERO CRD42018077333; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77333.
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Affiliation(s)
- Alice Grady
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Nicole Pearson
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Hannah Lamont
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Lucy Leigh
- Data Sciences, Hunter Medical Research Institute, New Lambton, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton, Australia
| | - Meghan Finch
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Matthew Mclaughlin
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Tessa Delaney
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Rebecca Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, Melbourne, Australia
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Lim GP, Appalasamy JR, Ahmad B, Quek KF, Ramadas A. Social Media-Delivered Lifestyle Interventions Among Individuals Living with Diabetes and Prediabetes: A Scoping Review. Curr Nutr Rep 2023; 12:721-732. [PMID: 37976017 DOI: 10.1007/s13668-023-00507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW There is a lack of synthesized evidence on social media-delivered lifestyle interventions for managing and preventing diabetes. This scoping review aims to evaluate recently reported lifestyle interventions delivered on social media for individuals with diabetes and prediabetes. RECENT FINDINGS Twelve studies were included in this review. A team of multidisciplinary healthcare professionals coordinated most interventions, half of which lasted for 6 months, and used a combination of videos, texts, images or audio to deliver the educational materials. The glycosylated hemoglobin (HbA1c) level improved in most of the studies, followed by diabetes self-care and fasting plasma glucose. The dietary intakes were only assessed in two interventions among the individuals with prediabetes and showed promising improvements. This scoping review provides a holistic overview of the recent designs of lifestyle interventions for diabetes management and prevention on social media. This is essential for various healthcare professionals and stakeholders to formulate and implement population-based, cost-effective interventions in combating diabetes using social media.
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Affiliation(s)
- Geok Pei Lim
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | | | - Badariah Ahmad
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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21
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Blok DJ, Simoski B, van Woudenberg TJ, Buijzen M. The Usefulness of Web-Based Communication Data for Social Network Health Interventions: Agent-Based Modeling Study. JMIR Pediatr Parent 2023; 6:e44849. [PMID: 37991813 DOI: 10.2196/44849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/01/2023] [Accepted: 10/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Social network interventions are an effective approach to promote physical activity. These interventions are traditionally designed using self-reported peer nomination network data to represent social connections. However, there is unexplored potential in communication data exchanged through web-based messaging apps or social platforms, given the availability of these data, the developments in artificial intelligence to analyze these data, and the shift of personal communication to the web sphere. The implications of using web-based versus offline social networks on the effectiveness of social network interventions remain largely unexplored. OBJECTIVE This study aims to investigate the differences in the impact of social network interventions on physical activity levels (PALs) between networks derived from web-based communication and peer nomination data. METHODS We used the data on sociometric questionnaires, messages from a web-based communication app, and PAL (number of steps per day) of 408 participants in 21 school classes. We applied social network analysis to identify influential peers and agent-based modeling to simulate the diffusion of PAL and explore the impact of social network interventions on PAL among adolescents in school classes. Influential peers (n=63) were selected based on centrality measures (ie, in-degree, closeness, and betweenness) to spread the intervention. They received health education, which increased their PAL by 17%. In sensitivity analyses, we tested the impact of a 5%, 10%, and 20% increase in PAL among influential peers. RESULTS There was a 24%-27% overlap in selected influential peers between the 2 network representations. In general, the simulations showed that interventions could increase PAL by 5.0%-5.8% within 2 months. However, the predicted median impact on PAL was slightly higher in networks based on web-based communication data than peer nomination data for in-degree (5.7%, IQR 5.5%-6.1% vs 5.5%, IQR 5.2%-5.8%; P=.002), betweenness (5.6%, IQR 5.4%-5.9% vs 5.0%, IQR 4.7%-5.3%; P<.001), and closeness centrality (5.8%, IQR 5.6%-6.1% vs 5.3%, IQR 5.0%-5.6%; P<.001). A large variation in impact was observed between school classes (range 1.5%-17.5%). Lowering the effectiveness of health education from 17% to 5% would reduce the overall impact of the social network intervention by 3-fold in both networks. CONCLUSIONS Our findings showed that network interventions based on web-based communication data could increase PAL. Web-based communication data may therefore be a valuable addition to peer nomination data for future social network intervention design. Artificial intelligence methods, including agent-based modeling, can help to design these network interventions and provide insights into the role of network characteristics in their effectiveness.
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Affiliation(s)
- David J Blok
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Bojan Simoski
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Thabo J van Woudenberg
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Centre for Language Studies, Radboud University, Nijmegen, Netherlands
| | - Moniek Buijzen
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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22
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Ambros-Antemate JF, Beristain-Colorado MDP, Vargas-Treviño M, Gutiérrez-Gutiérrez J, Hernández-Cruz PA, Gallegos-Velasco IB, Moreno-Rodríguez A. Improving Adherence to Physical Therapy in the Development of Serious Games: Conceptual Framework Design Study. JMIR Form Res 2023; 7:e39838. [PMID: 37948110 PMCID: PMC10674146 DOI: 10.2196/39838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 04/25/2023] [Accepted: 10/14/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Insufficient levels of treatment adherence can have adverse effects on the outcomes of physical rehabilitation. To address this issue, alternative approaches to traditional therapies, such as serious games, have been designed to enhance adherence. Nevertheless, there remain gaps in the development of serious games concerning the effective implementation of motivation, engagement, and the enhancement of treatment adherence. OBJECTIVE This study aims to design a conceptual framework for the development of serious games that incorporate essential adherence factors to enhance patient compliance with physical rehabilitation programs. METHODS We formulated a conceptual framework using iterative techniques inspired by a conceptual framework analysis. Initially, we conducted a comprehensive literature review, concentrating on the critical adherence factors in physical rehabilitation. Subsequently, we identified, categorized, integrated, and synthesized the concepts derived from the literature review to construct the conceptual framework. RESULTS The framework resembles a road map, comprising 3 distinct phases. In the initial phase, the patient's characteristics are identified through an initial exploration. The second phase involves the development of a serious game, with a focus on enhancing treatment adherence by integrating the key adherence factors identified. The third phase revolves around the evaluation of the serious game. These phases are underpinned by 2 overarching themes, namely, a user-centered design and the GameFlow model. CONCLUSIONS The conceptual framework offers a detailed, step-by-step guide for creating serious games that incorporate essential adherence factors, thereby contributing to improved adherence in the physical rehabilitation process. To establish its validity, further evaluations of this framework across various physical rehabilitation programs and user groups are necessary.
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Affiliation(s)
| | | | - Marciano Vargas-Treviño
- Facultad de Sistemas Biológicos e Innovación Tecnológica, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca de Juárez, Mexico
| | - Jaime Gutiérrez-Gutiérrez
- Facultad de Sistemas Biológicos e Innovación Tecnológica, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca de Juárez, Mexico
| | - Pedro Antonio Hernández-Cruz
- Laboratorio de genómica y proteómica, Centro de investigación Universidad Nacional Autónoma de México-Universidad Autónoma "Benito Juárez" de Oaxaca, Facultad de Medicina y Cirugía, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca de Juárez, Mexico
| | - Itandehui Belem Gallegos-Velasco
- Laboratorio de genómica y proteómica, Centro de investigación Universidad Nacional Autónoma de México-Universidad Autónoma "Benito Juárez" de Oaxaca, Facultad de Medicina y Cirugía, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca de Juárez, Mexico
| | - Adriana Moreno-Rodríguez
- Facultad de Ciencias Químicas, Universidad Autónoma "Benito Juárez" de Oaxaca, Oaxaca de Juárez, Mexico
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23
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Monroe CM, Cai B, Edney S, Jake-Schoffman DE, Brazendale K, Bucko A, Armstrong B, Yang CH, Turner-McGrievy G. Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot. Int J Behav Nutr Phys Act 2023; 20:129. [PMID: 37924083 PMCID: PMC10623775 DOI: 10.1186/s12966-023-01530-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The use of health technologies and gamification to promote physical activity has increasingly been examined, representing an opportunistic method for harnessing social support inherent within existing social ties. However, these prior studies have yielded mixed findings and lacked long-term follow-up periods. Thus, a pilot cluster randomized controlled trial was conducted to gauge the feasibility and preliminary efficacy of a digital gamification-based physical activity promotion approach among teams of insufficiently active adults with existing social ties. METHODS Teams (N = 24; 116 total participants) were randomized to either a 12-week intervention (Fitbit, step goals, app, feedback; TECH) or the same program plus gamification (TECH + Gamification). Mixed effects models were used to compare group differences in treatment adherence, and changes in social support, steps, and moderate-to-vigorous physical activity at 12 weeks and 52 weeks from baseline, adjusted for sociodemographic characteristics and team size. RESULTS TECH had a lower mean number of days of Fitbit self-monitoring versus TECH + Gamification during the intervention (adjusted difference: -.30; 95% CI, -.54 to -.07; P = .01). Post-intervention, TECH had 47% lower odds of self-monitoring 7 days per week versus TECH + Gamification (.53; 95% CI, .31 to .89; P = .02). No differences were observed between TECH + Gamification and TECH in increases in social support (0.04; 95% CI, -.21 to .29; P = .76), ActiGraph-measured daily steps (-425; 95% CI, -1065 to 215; P = .19), or moderate-to-vigorous physical activity minutes (-3.36; 95% CI, -8.62 to 1.91; P = .21) from baseline to 12 weeks or in the regression of these improvements by 1 year (Ps > .05). Although not significant in the adjusted models (Ps > .05), clinically meaningful differences in Fitbit-measured daily steps (TECH, 7041 ± 2520; TECH + Gamification, 7988 ± 2707) and active minutes (TECH, 29.90 ± 29.76; TECH + Gamification, 36.38 ± 29.83) were found during the intervention. CONCLUSIONS A gamified physical activity intervention targeting teams of adults with existing social ties was feasible and facilitated favorable, clinically meaningful additive physical activity effects while in place but did not drive enhanced, long-term physical activity participation. Future investigations should explore optimal team dynamics and more direct ways of leveraging social support (training teams; gamifying social support). TRIAL REGISTRATION Clinicaltrials.gov ( NCT03509129 , April 26, 2018).
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Affiliation(s)
- Courtney M Monroe
- Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Suite 403G, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Bo Cai
- Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Discovery 1 Building, Room 460, 915 Greene Street, Columbia, SC, 29208, USA
| | - Sarah Edney
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building (Block MD1), 12 Science Drive 2, #11-01, Singapore, 117549, Singapore
| | - Danielle E Jake-Schoffman
- College of Health and Human Performance, Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Keith Brazendale
- College of Health Professions and Sciences, Department of Health Sciences, University of Central Florida, HS II, Room 210A, 12805 Pegasus Drive, Orlando, FL, 32816, USA
| | - Agnes Bucko
- College of Health and Human Services, University of North Carolina-Charlotte, 8844 Craver Road, Charlotte, NC, 28223, USA
| | - Bridget Armstrong
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Public Health Research Center, Room 132, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Chih-Hsiang Yang
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Discovery 1 Building, Room 403E, 915 Greene Street, Columbia, SC, 29208, USA
| | - Gabrielle Turner-McGrievy
- Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Room 552, 915 Greene Street, Columbia, SC, 29208, USA
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24
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Hermsen S, Van Abswoude F, Steenbergen B. The Effect of Social Networks on Active Living in Adolescents: Qualitative Focus Group Study. JMIR Form Res 2023; 7:e46350. [PMID: 37796582 PMCID: PMC10587806 DOI: 10.2196/46350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/17/2023] [Accepted: 08/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Participation in organized sports and other forms of active living have important health benefits in adolescence and adulthood. Unfortunately, the transition to secondary school has been shown to be a barrier to participation. Social networks can play important roles in activating adolescents, and information and communication technology (ICT) interventions can augment this role. To date, there are few insights into what adolescents themselves think and feel about barriers to and motivators for active living, the role of their social networks in active living, and the potential of ICT for physical activity (PA). OBJECTIVE This study aimed to gather insights into the perspectives of adolescents aged 12 to 14 years on active living and sports participation, motivators and demotivators for active living, and the potential roles of their social network and of ICT. METHODS A total of 26 adolescents aged 12 to 14 years from different levels of Dutch secondary schools participated in 1 of 5 semistructured focus group interviews, in which they talked about sports and PA, their social networks, their ICT use, and the role of social networks and ICT in PA. All interviews were transcribed and analyzed using a thematic qualitative approach. RESULTS The study showed that all participants were physically active, although the transition to secondary school made this difficult, mostly because of time constraints. Participants saw positive physical and mental health effects as important benefits of active living. They regarded social benefits as strong motivators for active living: being together, making friends, and having fun together. However, the social network could also demotivate through negative peer judgment and negative feedback. Participants were willing to share their own positive experiences and hear about those from close peers and friends but would not share their own (and were not interested in others') negative experiences or personal information. Participants were mainly interested in descriptive norms set by others and obtained inspiration from others for PA. With respect to using ICT for active living, participants stated a preference for social challenges among friends, personalized feedback, goals, activities, and rewards. Competition was seen as less important or even unattractive. If mentioned, participants felt that this should be with friends, or peers of a similar level, with fun being more important than the competition itself. CONCLUSIONS This study shows that adolescents feel that their social network is and can be a strong driver of active living. They are willing to use ICT-based solutions that make use of social networks for PA as long as these solutions involve their current (close) network and use an approach based on being together and having fun together.
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Affiliation(s)
- Sander Hermsen
- Precision Health and Nutrition Group, OnePlanet Research Centre, Wageningen, Netherlands
| | - Femke Van Abswoude
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands
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25
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Davies B, Turner M, Udell J. Are humorous or distractor images more effective than self-compassion messages for combatting the negative body image consequences of social media? An experimental test of possible micro-intervention stimuli. Body Image 2023; 46:356-371. [PMID: 37473707 DOI: 10.1016/j.bodyim.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
Appearance-focused images on social media are thought to be particularly detrimental for body image. However, social media sites can also be used to encourage positive health behaviours. Three linked experiments with 620 Instagram users explored the protective capabilities of appearance-related self-compassion and appearance-related humorous messages for women's body image during Instagram use. Using simulated Instagram browsing tasks, participants were exposed to a set of fitspiration Instagram posts mixed with either self-compassion or humorous body image messages, or appearance-neutral images. Results indicated that appearance-related self-compassion and humorous messages were not more effective at protecting against negative appearance and life satisfaction outcomes than appearance-neutral images, and did not influence appearance comparison (Experiment 1), even when the personal relevance to participants' health was reinforced through experimental manipulation (Experiment 2). Rather, the presence of any image which did not contain pictures of women, regardless of image content, led to improved body image outcomes compared to exposure to fitspiration images alone (Experiment 3). Interpersonal factors such as the similarity of a female target's appearance also influenced the nature of comparisons made. The study highlights the importance of diluting appearance-focused content with other social media images in ongoing research practice and for user well-being.
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Affiliation(s)
- Bryony Davies
- Department of Psychology, King Henry Building, University of Portsmouth, Portsmouth PO1 2DY, United Kingdom.
| | - Mark Turner
- Department of Psychology, King Henry Building, University of Portsmouth, Portsmouth PO1 2DY, United Kingdom
| | - Julie Udell
- Department of Psychology, King Henry Building, University of Portsmouth, Portsmouth PO1 2DY, United Kingdom
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26
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Vandelanotte C, Trost S, Hodgetts D, Imam T, Rashid M, To QG, Maher C. Increasing physical activity using an just-in-time adaptive digital assistant supported by machine learning: A novel approach for hyper-personalised mHealth interventions. J Biomed Inform 2023; 144:104435. [PMID: 37394024 DOI: 10.1016/j.jbi.2023.104435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE Physical inactivity is a leading modifiable cause of death and disease worldwide. Population-based interventions to increase physical activity are needed. Existing automated expert systems (e.g., computer-tailored interventions) have significant limitations that result in low long-term effectiveness. Therefore, innovative approaches are needed. This special communication aims to describe and discuss a novel mHealth intervention approach that proactively offers participants with hyper-personalised intervention content adjusted in real-time. METHODS Using machine learning approaches, we propose a novel physical activity intervention approach that can learn and adapt in real-time to achieve high levels of personalisation and user engagement, underpinned by a likeable digital assistant. It will consist of three major components: (1) conversations: to increase user's knowledge on a wide range of activity-related topics underpinned by Natural Language Processing; (2) nudge engine: to provide users with hyper-personalised cues to action underpinned by reinforcement learning (i.e., contextual bandit) and integrating real-time data from activity tracking, GPS, GIS, weather, and user provided data; (3) Q&A: to facilitate users asking any physical activity related questions underpinned by generative AI (e.g., ChatGPT, Bard) for content generation. RESULTS The detailed concept of the proposed physical activity intervention platform demonstrates the practical application of a just-in-time adaptive intervention applying various machine learning techniques to deliver a hyper-personalised physical activity intervention in an engaging way. Compared to traditional interventions, the novel platform is expected to show potential for increased user engagement and long-term effectiveness due to: (1) using new variables to personalise content (e.g., GPS, weather), (2) providing behavioural support at the right time in real-time, (3) implementing an engaging digital assistant and (4) improving the relevance of content through applying machine learning algorithms. CONCLUSION The use of machine learning is on the rise in every aspect of today's society, however few attempts have been undertaken to harness its potential to achieve health behaviour change. By sharing our intervention concept, we contribute to the ongoing dialogue on creating effective methods for promoting health and well-being in the informatics research community. Future research should focus on refining these techniques and evaluating their effectiveness in controlled and real-world circumstances.
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Affiliation(s)
- Corneel Vandelanotte
- Appleton Institute, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia.
| | - Stewart Trost
- School of Human Movement and Nutrition Science, The University of Queensland, St Lucia, Queensland 4072, Australia.
| | - Danya Hodgetts
- Appleton Institute, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia.
| | - Tasadduq Imam
- School of Business and Law, Central Queensland University, 120 Spencer Street, Melbourne, Victoria 3000, Australia.
| | - Mamunur Rashid
- School of Engineering and Technology, Central Queensland University, 120 Spencer Street, Melbourne, Victoria 3000, Australia.
| | - Quyen G To
- Appleton Institute, Central Queensland University, Bruce Highway, Rockhampton, Queensland 4702, Australia.
| | - Carol Maher
- Allied Health and Human Performance, University of South Australia, City East Campus, Adelaide, South Australia 5001, Australia.
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27
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McDermott KT, Noake C, Wolff R, Bauld L, Espina C, Foucaud J, Steindorf K, Thorat MA, Weijenberg MP, Schüz J, Kleijnen J. Digital interventions to moderate physical inactivity and/or nutrition in young people: a Cancer Prevention Europe overview of systematic reviews. Front Digit Health 2023; 5:1185586. [PMID: 37534029 PMCID: PMC10393256 DOI: 10.3389/fdgth.2023.1185586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/18/2023] [Indexed: 08/04/2023] Open
Abstract
Background Strategies to increase physical activity (PA) and improve nutrition would contribute to substantial health benefits in the population, including reducing the risk of several types of cancers. The increasing accessibility of digital technologies mean that these tools could potentially facilitate the improvement of health behaviours among young people. Objective We conducted a review of systematic reviews to assess the available evidence on digital interventions aimed at increasing physical activity and good nutrition in sub-populations of young people (school-aged children, college/university students, young adults only (over 18 years) and both adolescent and young adults (<25 years)). Methods Searches for systematic reviews were conducted across relevant databases including KSR Evidence (www.ksrevidence.com), Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE; CRD). Records were independently screened by title and abstract by two reviewers and those deemed eligible were obtained for full text screening. Risk of bias (RoB) was assessed with the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS) tool. We employed a narrative analysis and developed evidence gap maps. Results Twenty-four reviews were included with at least one for each sub-population and employing a range of digital interventions. The quality of evidence was limited with only one of the 24 of reviews overall judged as low RoB. Definitions of "digital intervention" greatly varied across systematic reviews with some reported interventions fitting into more than one category (i.e., an internet intervention could also be a mobile phone or computer intervention), however definitions as reported in the relevant reviews were used. No reviews reported cancer incidence or related outcomes. Available evidence was limited both by sub-population and type of intervention, but evidence was most pronounced in school-aged children. In school-aged children eHealth interventions, defined as school-based programmes delivered by the internet, computers, tablets, mobile technology, or tele-health methods, improved outcomes. Accelerometer-measured (Standardised Mean Difference [SMD] 0.33, 95% Confidence Interval [CI]: 0.05 to 0.61) and self-reported (SMD: 0.14, 95% CI: 0.05 to 0.23) PA increased, as did fruit and vegetable intake (SMD: 0.11, 95% CI: 0.03 to 0.19) (review rated as low RoB, minimal to considerable heterogeneity across results). No difference was reported for consumption of fat post-intervention (SMD: -0.06, 95% CI: -0.15 to 0.03) or sugar sweetened beverages(SSB) and snack consumption combined post-intervention (SMD: -0.02, 95% CI:-0.10 to 0.06),or at the follow up (studies reported 2 weeks to 36 months follow-up) after the intervention (SMD:-0.06, 95% CI: -0.15 to 0.03) (review rated low ROB, minimal to substantial heterogeneity across results). Smartphone based interventions utilising Short Messaging Service (SMS), app or combined approaches also improved PA measured using objective and subjective methods (SMD: 0.44, 95% CI: 0.11 to 0.77) when compared to controls, with increases in total PA [weighted mean difference (WMD) 32.35 min per day, 95% CI: 10.36 to 54.33] and in daily steps (WMD: 1,185, 95% CI: 303 to 2,068) (review rated as high RoB, moderate to substantial heterogeneity across results). For all results, interpretation has limitations in terms of RoB and presence of unexplained heterogeneity. Conclusions This review of reviews has identified limited evidence that suggests some potential for digital interventions to increase PA and, to lesser extent, improve nutrition in school-aged children. However, effects can be small and based on less robust evidence. The body of evidence is characterised by a considerable level of heterogeneity, unclear/overlapping populations and intervention definitions, and a low methodological quality of systematic reviews. The heterogeneity across studies is further complicated when the age (older vs. more recent), interactivity (feedback/survey vs. no/less feedback/surveys), and accessibility (type of device) of the digital intervention is considered. This underscores the difficulty in synthesising evidence in a field with rapidly evolving technology and the resulting challenges in recommending the use of digital technology in public health. There is an urgent need for further research using contemporary technology and appropriate methods.
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Affiliation(s)
| | - Caro Noake
- Kleijnen Systematic Reviews Ltd., York, United Kingdom
| | - Robert Wolff
- Kleijnen Systematic Reviews Ltd., York, United Kingdom
| | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - Carolina Espina
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Jérôme Foucaud
- Institut National du Cancer (INCa), Boulogne-Billancourt, France
- Université Sorbonne Paris Nord, Laboratoire Éducations et Pratiques de Santé (UR 3412), Bobigny, France
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Mangesh A. Thorat
- Breast Services, Guy's Hospital, Guy's and St Thomas’ NHS Foundation Trust, Great Maze Pond, London, United Kingdom
- Centre for Cancer Prevention, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd., York, United Kingdom
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Choi DH, Noh GY. The Impact of Social Media on Preventive Behavior During the COVID-19 Outbreak in South Korea: The Roles of Social Norms and Self-Efficacy. SAGE OPEN 2023; 13:21582440231184969. [PMID: 37456583 PMCID: PMC10333550 DOI: 10.1177/21582440231184969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Social media are important channels to propagate health information and influence preventive behavior during a public health crisis, as witnessed during the coronavirus pandemic (COVID-19). This study explored the association between social media use and preventive behavior during the outbreak of COVID-19 in South Korea. Using the national survey data (N = 1,500), the study examined the mediating role of social norms in the association between social media use for news and information about COVID-19 and preventive behavior. In addition, the study tested the moderating effect of self-efficacy on the mediating path of social media use for preventive behavior via social norms. Conducting a moderated mediation analysis method, this study found that social norms mediated the relationship between social media use and preventive behavior (b = 0.046). Moreover, the study revealed that the indirect relationship between social media use and preventive behavior through social norms becomes stronger as an individual's level of self-efficacy decreases (low: b = 0.044, middle: b = 0.036, and high: b = 0.030). The study provides empirical evidence of the beneficial impact of social media use on preventive behavior. The findings of the study recommend promoting messages on social norms through social media for facilitating preventive behavior.
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29
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Johnson CM, D'Eramo Melkus G, Reagan L, Pan W, Amarasekara S, Pereira K, Hassell N, Nowlin S, Vorderstrasse A. Learning in a Virtual Environment to Improve Type 2 Diabetes Outcomes: Randomized Controlled Trial. JMIR Form Res 2023; 7:e40359. [PMID: 36962700 PMCID: PMC10160930 DOI: 10.2196/40359] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/17/2022] [Accepted: 03/23/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Given the importance of self-management in type 2 diabetes mellitus (T2DM), a major aspect of health is providing diabetes self-management education and support. Known barriers include access, availability, and the lack of follow through on referral to education programs. Virtual education and support have increased in use over the last few years. OBJECTIVE The purpose of the Diabetes Learning in a Virtual Environment (LIVE) study was to compare the effects of the LIVE intervention (educational 3D world) to a diabetes self-management education and support control website on diet and physical activity behaviors and behavioral and metabolic outcomes in adults with T2DM over 12 months. METHODS The LIVE study was a 52-week multisite randomized controlled trial with longitudinal repeated measures. Participants were randomized to LIVE (n=102) or a control website (n=109). Both contained the same educational materials, but the virtual environment was synchronous and interactive, whereas the control was a flat website. Data were collected at baseline and 3, 6, and 12 months using surveys and clinical, laboratory, and Fitbit measures. Descriptive statistics included baseline characteristics and demographics. The effects of the intervention were initially examined by comparing the means and SDs of the outcomes across the 4 time points between study arms, followed by multilevel modeling on trajectories of the outcomes over the 12 months. RESULTS This trial included 211 participants who consented. The mean age was 58.85 (SD 10.1) years, and a majority were White (127/211, 60.2%), non-Hispanic (198/211, 93.8%), married (107/190, 56.3%), and female (125/211, 59.2%). Mean hemoglobin A1c (HbA1c) level at baseline was 7.64% (SD 1.79%) and mean BMI was 33.51 (SD 7.25). We examined weight loss status versus randomized group, where data with no weight change were eliminated, and the LIVE group experienced significantly more weight loss than the control group (P=.04). There were no significant differences between groups in changes in physical activity and dietary outcomes (all P>.05), but each group showed an increase in physical activity. Both groups experienced a decrease in mean HbA1c level, systolic and diastolic blood pressure, cholesterol, and triglycerides over the course of 12 months of study participation, including those participants whose baseline HbA1c level was 8.6% or higher. CONCLUSIONS This study confirmed that there were minor positive changes on glycemic targets in both groups over the 12-month study period; however, the majority of the participants began with optimal HbA1c levels. We did find clinically relevant metabolic changes in those who began with an HbA1c level >8.6% in both groups. This study provided a variety of resources to our participants in both study groups, and we conclude that a toolkit with a variety of services would be helpful to improving self-care in the future for persons with T2DM. TRIAL REGISTRATION ClinicalTrials.gov NCT02040038; https://clinicaltrials.gov/ct2/show/NCT02040038.
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Affiliation(s)
- Constance M Johnson
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
- School of Nursing, Duke University, Durham, NC, United States
| | - Gail D'Eramo Melkus
- Rory Myers College of Nursing, New York University, New York, NY, United States
| | - Louise Reagan
- Rory Myers College of Nursing, New York University, New York, NY, United States
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Wei Pan
- School of Nursing, Duke University, Durham, NC, United States
| | | | | | - Nancy Hassell
- School of Nursing, Duke University, Durham, NC, United States
| | - Sarah Nowlin
- Rory Myers College of Nursing, New York University, New York, NY, United States
- Department of Nursing, Mount Sinai Hospital, New York, NY, United States
| | - Allison Vorderstrasse
- School of Nursing, Duke University, Durham, NC, United States
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, United States
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Curtis RG, Prichard I, Gosse G, Stankevicius A, Maher CA. Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts. BMC Public Health 2023; 23:421. [PMID: 36864397 PMCID: PMC9979526 DOI: 10.1186/s12889-023-15232-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/07/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects. METHODS This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages. RESULTS Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κq) was high (Stage 1: 92% agreement [95% CI 87, 97], κq 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κq 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%). CONCLUSION While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.
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Affiliation(s)
- Rachel G Curtis
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Ivanka Prichard
- College of Nursing and Health Sciences, SHAPE Research Centre, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Georgia Gosse
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Anna Stankevicius
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Carol A Maher
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
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ElNaghy R, Al-Qawasmi R, Hasanin M. Does using mobile applications and social media-based interventions induce beneficial behavioral changes among orthodontic patients? Evid Based Dent 2023; 24:26-27. [PMID: 36882496 DOI: 10.1038/s41432-023-00859-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 05/10/2023]
Abstract
DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled clinical trials (CCTs). The protocol of the study was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019157298). DATA SOURCES Seven electronic databases (MEDLINE, Web of Science Core Collection, Unpublished Clinical Trials accessed through clinicaltrials.gov, Embase, LILACS, ProQuest Database, The Cochrane Library) were searched. Additionally, the reference lists of the included studies were hand searched. STUDY SELECTION Clinical trials (RCT and CCT) that assessed the impact of the interventional use of mobile applications and social media among orthodontic patients were included. The review question was defined in PICO format as follows: population (P) = patients (no age restriction) undergoing orthodontic treatment using fixed, removable, or functional appliances, or patients in the retention phase that are wearing fixed or removable retainers; intervention (I) = mobile applications and social media-based interventions; comparison (C) = control group that did not receive any adjunctive intervention; outcome (O) = behavior changes in orthodontic patients after receipt of the intervention. Two authors independently conducted literature search from inception up to March 2021. DATA ANALYSIS Social media-based interventions and mobile applications (or bespoke) were used in the form of reminders (WhatsApp reminders) and provision of information including YouTube videos and Instagram posts. Primary outcomes included adherence to wearing appliances or adjuncts, oral hygiene levels, oral health-related behaviors, periodontal outcomes, appointment attendance, knowledge, and related iatrogenic effects. Treatment-related experiences and patient-reported outcomes were assessed as secondary outcomes. RESULTS 16 studies (14 RCTs and 2 CCTs) were included in the qualitative synthesis, of which only 7 studies were included in the quantitative synthesis (meta-analysis). Results from meta-analyses showed that the intervention was favored in relation to gingival index (GI) (number of studies = 4, standardized mean difference [SMD] = -0.81, 95% confidence interval [CI] = -1.35 to -0.28, P = 0.00, certainty of evidence = very low), plaque index (PI) (number of studies = 7, SMD = -0.91 [95% CI, -1.64 to -0.19], P = 0.01, certainty of evidence = very low), and bleeding index (BI) (number of studies = 4, SMD = -0.22 [95% CI, -0.50 to 0.05], P = 0.11, certainty of evidence = high). Sensitivity analysis was performed (including additional 3 studies for GI and 5 studies for PI), which also favored the intervention in relation to GI (number of studies = 7, SMD = -0.60 [95% CI, -1.01 to -0.18], P = 0.00, certainty of evidence = very low), and PI (number of studies = 12, SMD = -0.67 [95% CI, -1.14 to -0.19], P = 0.01, certainty of evidence = very low). CONCLUSIONS Limited evidence supports beneficial behavior change among orthodontic patients when using mobile applications or social media-based interventions.
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Affiliation(s)
- Rahma ElNaghy
- Department of Graduate Orthodontics, University of Detroit Mercy, Detroit, MI, USA.
| | - Riyad Al-Qawasmi
- Department of Graduate Orthodontics, University of Detroit Mercy, Detroit, MI, USA
| | - Majd Hasanin
- Department of Graduate Orthodontics, University of Detroit Mercy, Detroit, MI, USA
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Saquib J, Alhomaidan HT, Al-Mohaimeed A, Aljaghwani L, Al-Mohaimeed R, Alghadhiyah D, Altwijri R, Alazmi AL, Al-Mohaimeed FA, Alhamed GS, Alsowiyan AA, Alharbi AM, Saquib N. Effect of a WhatsApp walking trial on daily steps among female Saudi Arabian university students. Int J Health Sci (Qassim) 2023; 17:16-21. [PMID: 36891045 PMCID: PMC9986880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Objective Physical inactivity in Saudi women is high, even among young women (60% of university students are physically inactive). We aimed to investigate the effect of a physical activity intervention on daily walking among female students at a Saudi university. Methods Two hundred and seven female students (mean age: 22.6 ± 1.3; body mass index: 24.6 ± 5.9) participated in a parallel-group randomized trial. The intervention group wore pedometers and received health-promotion messages for 12 weeks through WhatsApp®; the control group received a similar number of messages unrelated to health. Average daily steps and self-reported activity were assessed at baseline and after 3 months. Analysis followed an intention-to-treat approach. Group differences in average daily steps were assessed using a two (group) by 2 (time) ANOVA. F-tests for main effects and the interaction were evaluated; P < 0.05 was considered significant. Results There was a significant group-by-time interaction, that is, the intervention group had a significantly higher change in daily steps compared to the control group (+576 vs. -525; F = 4.33, P = 0.04). Self-reported daily activity was not significantly different by group. Conclusions The intervention was effective at improving the number of daily steps in young women. Future studies could test this intervention among other student groups.
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Affiliation(s)
- Juliann Saquib
- Department of Clinical Sciences, College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Saudi Arabia
| | - Homaidan T. Alhomaidan
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Abdulrahman Al-Mohaimeed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Lujain Aljaghwani
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Raghad Al-Mohaimeed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Darren Alghadhiyah
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Raghad Altwijri
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Amal Lafi Alazmi
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Fatmah Ali Al-Mohaimeed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Ghadah Saleh Alhamed
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Asma Abdullah Alsowiyan
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Ashwaq Mohammed Alharbi
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Nazmus Saquib
- Department of Clinical Sciences, College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Saudi Arabia
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Basuodan RM, Bin sheeha BH, Basoudan NE, Abdljabbarl NA, Aldhahi MI. Tele-Physical Activity Promotion Program among College Students during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020332. [PMID: 36837532 PMCID: PMC9960905 DOI: 10.3390/medicina59020332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023]
Abstract
Background and Objectives: During the COVID-19 pandemic, lockdown and distance learning affected physical activity (PA) levels among college students. The aims were to assess the effectiveness of a tele-health PA promotion program for 6 weeks, among junior college students, on PA level and on the proportion of physically active students during the pandemic. Materials and Methods: A pre-post study design was conducted on 46 students aged 19 (±0.9) years old in Saudi Arabia. The study consisted of online introductory and educational PA classes, followed by a 6-week course during which students received daily online PA promotive messages. Wilcoxon signed-rank and McNemar's tests were used to measure the mean differences in PA level and the changes in proportion of physically active students before and after the program, respectively. Results: The proportion of students who perform walking increased significantly from 47.4% to 68.4% (p = 0.02), while the number of students who perform moderate PA in their leisure time increased significantly from 38.9% to 69.4% (p = 0.02). No significant differences were detected between other PA levels. Conclusions: This program is effective in encouraging more college students to be physically active, but not in improving PA levels. Larger scale studies using PA objective measurement tools are needed.
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Affiliation(s)
- Reem M. Basuodan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Bodor H. Bin sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Nada E. Basoudan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Nada A. Abdljabbarl
- College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
- Correspondence:
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Wang Q, Collet JP, Mei J, Chen G, Huang S, Yang Y, Wang W, Ding F. Complex interactive multimodal intervention to improve personalized stress management among healthcare workers in China: A knowledge translation protocol. Digit Health 2023; 9:20552076231184052. [PMID: 37545629 PMCID: PMC10399255 DOI: 10.1177/20552076231184052] [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: 11/07/2022] [Accepted: 06/07/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Numerous stress management interventions have been implemented in the workplace, but few are adapted to the healthcare setting. Due to the nature of their jobs, healthcare workers (HCWs) may find it difficult to adopt recommended stress management strategies. We present the protocol for a 12-week personalized stress management intervention among HCWs to change their behavior as well as improve physiological/psychological outcomes. Methods It is a pragmatic quasi-experimental study involving stressed HCWs from two general hospitals in Wuhan, China. The intervention group will receive a complex interactive multimodal intervention, including advanced education via mobile connection, participation in a web-based social network, tailored feedback, and the support of a nurse coach, while the control group will engage in self-guided stress management. Results The primary outcome is centered on behavioral measures, namely improvements in stress management practice frequency after a 12-week intervention. The secondary outcomes are the changes in stress-related physiological indices (i.e. high frequency variability and normalized unit assessed by Holter) and psychological indicators (scores on the Perceived Stress Scale and Depression, Anxiety, Stress Scale) following 12 weeks of treatment. Conclusion The knowledge translation intervention builds on a body of work defining the role of individualized instruction and feedback intervention, as well as group intervention through WeChat social network and personalized coaching. We believe this novel intervention will help HCWs promote their stress management awareness and skills, and ultimately benefit their long-term health. Trial Registration ClinicalTrials.gov., NCT05239065. Registered 14 February 2022-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05239065.
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Affiliation(s)
- Quan Wang
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Nursing College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jean-Paul Collet
- UBC Department of Pediatrics and Children's Hospital Research Institute, Vancouver, Canada
| | - Junhua Mei
- Department of Neurology, The First Hospital of Wuhan City, Wuhan, China
| | - Guohua Chen
- Department of Neurology, The First Hospital of Wuhan City, Wuhan, China
| | - Sufang Huang
- Nursing College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengfei Ding
- Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Canfield SM, Canada KE. Systematic Review of Online Interventions to Reduce Perinatal Mood and Anxiety Disorders in Underserved Populations. J Perinat Neonatal Nurs 2023; 37:14-26. [PMID: 36707743 DOI: 10.1097/jpn.0000000000000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Online health interventions increase access to care, are acceptable to end users and effective for treating mental and physical health disorders. However, less is known about interventions to prevent and treat perinatal mood and anxiety disorders (PMADs). This review synthesizes existing research on PMAD prevention and treatment by exploring the treatment modalities and efficacy of online interventions and examining the inclusion of underserved populations in PMAD research. METHODS Using PRISMA guidelines, authors conducted a systematic review of peer-reviewed literature published between 2008 and 2018 on online interventions aimed to prevent or treat PMADs. The authors also assessed quality. Eligible articles included perinatal women participating in preventive studies or those aimed to reduce symptoms of PMADs and utilized a Web-based, Internet, or smartphone technology requiring an online component. This study excluded telephone-based interventions that required one-on-one conversations or individualized, text-based responses without a Web-based aspect. RESULTS The initial search yielded 511 articles, and the final analysis included 23 articles reporting on 22 interventions. Most studies used an experimental design. However, no study achieved an excellent or good quality rating. Psychoeducation and cognitive-behavioral therapies (CBTs) were most common. Several interventions using CBT strategies significantly decreased depression or anxiety. Four studies recruited and enrolled mainly people identifying as low-income or of a racial or ethnic minority group. Attrition was generally high across studies. DISCUSSION More research using rigorous study designs to test PMAD interventions across all perinatal times is needed. Future research needs to engage diverse populations purposefully.
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Affiliation(s)
- Shannon M Canfield
- Family and Community Medicine (Dr Canfield), Center for Health Policy (Dr Canfield), and School of Social Work (Dr Canada), University of Missouri-Columbia
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Bender JL, Akinnibosun R, Puri N, D’Agostino N, Drake EK, Tsimicalis A, Howard AF, Garland SN, Chalifour K, Gupta AA. A comparison of the sociodemographic, medical, and psychosocial characteristics of adolescents and young adults diagnosed with cancer recruited in-person and online: A Canadian cross-sectional survey. Digit Health 2023; 9:20552076231205278. [PMID: 37900258 PMCID: PMC10605661 DOI: 10.1177/20552076231205278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Adolescents and young adults diagnosed with cancer (AYAs) are under-represented in research. The Internet and social media could increase the reach of recruitment efforts but may impact sample characteristics. This study evaluated the characteristics of AYAs recruited in-person at an urban hospital versus the Internet in terms of their sociodemographic and medical characteristics, and psychosocial wellbeing, and offers recommendation for increasing the inclusivity and representativeness of research samples. Methods Participant data from a cross-sectional survey of AYAs in Canada were evaluated. In-person hospital recruitment used a registry to identify patients attending ambulatory clinics. Internet recruitment included notices on hospital, team members', and community partners' social media channels, and email newsletters. Independent sample t-tests and Chi-squared tests were used to identify differences in participant sociodemographic, medical, and psychosocial characteristics based on recruitment source. Results Of 436 participants, 217 (49.8%) were recruited in-person and 219 (50.2%) online. Online participants were more likely: to be white (p < .001), women (p < .001), and Canadian-born (p < .001); to speak English at home (p < .001), live alone (p = .001) and live in rural settings (p = .014); and to be farther from diagnosis (p = .023), diagnosed with breast cancer (p < .001), and cancer free (p < .001) compared to the hospital sample. Online participants also reported higher anxiety, depression, and loneliness (p < .001), and lower social support (p < .001), self-efficacy for coping with cancer (p < .001), and life satisfaction (p = .006). Conclusions Online recruitment yielded a more geographically diverse but less sociodemographically diverse sample of AYAs who were farther from diagnosis and had poorer psychosocial wellbeing than in-person recruitment at an urban hospital. Future research efforts should consider partnering with under-represented communities and using targeted and stratified online and in-person recruitment strategies to achieve an inclusive and representative sample of AYAs.
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Affiliation(s)
- Jacqueline L Bender
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rukayyah Akinnibosun
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Natasha Puri
- Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Norma D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Emily K Drake
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - A Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Sheila N Garland
- Department of Psychology, Memorial University, St John's, NL,
Canada
| | | | - Abha A Gupta
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Schulte MT, Kelleghan AR. Adolescent, Parent, and Provider Perspectives of a Social-Media-Based Support Tool for Parents of Teens in Treatment for Substance Use. J Addict Nurs 2023; 34:E21-E27. [PMID: 34519687 PMCID: PMC8918025 DOI: 10.1097/jan.0000000000000423] [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] [Indexed: 11/26/2022]
Abstract
ABSTRACT Adolescent substance use disorder contributes to negative psychosocial and physical health outcomes. Parents best support their child's treatment and recovery when they are equipped with knowledge and skills; however, barriers hinder parental engagement. Social-media-based groups present an opportunity for parents who may not otherwise seek support. Qualitative data were collected via focus groups to examine the opinions of adolescents, parents, and treatment providers on the potential utility and possible concerns of a Facebook-based parent support group; input constituted the development phase for an online group (PURPOSE). Fifty-eight participants, recruited through adolescent treatment programs, took part in six focus groups: two parent ( n = 18), two adolescent ( n = 21), and two provider ( n = 19) groups. Groups were audio recorded and transcribed, and themes were extracted. Three main themes emerged: (a) traditional support groups and treatment services, (b) PURPOSE intervention content and delivery, and (c) issues related to PURPOSE implementation. Traditional treatment/support groups can be helpful, but participation in them is limited. Emotional support offered by peers is valuable, but parents also need and seek out psychoeducation, parenting skills, and self-care support. PURPOSE could offer easy access to skills and real-time peer support.
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Lyu JC, Afolabi A, White JS, Ling PM. Perceptions and Aspirations Toward Peer Mentoring in Social Media-Based Electronic Cigarette Cessation Interventions for Adolescents and Young Adults: Focus Group Study. JMIR Form Res 2022; 6:e42538. [PMID: 36454628 PMCID: PMC9756117 DOI: 10.2196/42538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Social media offer a promising channel to deliver e-cigarette cessation interventions to adolescents and young adults (AYAs); however, interventions delivered on social media face challenges of low participant retention and decreased engagement over time. Peer mentoring has the potential to ameliorate these challenges. OBJECTIVE The aim of this study was to understand, from both the mentee and potential mentor perspective, the needs, expectations, and concerns of AYAs regarding peer mentoring to inform the development of social media-based peer mentoring interventions for e-cigarette cessation among AYAs. METHODS Seven focus groups, including four mentee groups and three potential mentor groups, were conducted with 26 AYAs who had prior experience with e-cigarette use and attempts to quit in the context of a social media-based e-cigarette cessation intervention. Discussion focused on preferred characteristics of peer mentors, expectations about peer mentoring, mentoring mode, mentor training, incentives for peer mentors, preferred social media platforms for intervention delivery, supervision, and concerns. Focus group transcripts were coded and analyzed using a thematic analysis approach. RESULTS Overall, participants were receptive to peer mentoring in social media-based cessation interventions and believed they could be helpful in assisting e-cigarette cessation. Participants identified the most important characteristics of peer mentors to be of similar age and to be abstinent from e-cigarette use. Participants expected peer mentors would share personal experiences, provide emotional support, and send check-ins and reminders. Peer mentors supporting a group of mentees in combination with one-on-one mentoring as needed was the preferred mentoring mode. A group of 10 mentees with a mentor:mentee ratio of 1:3-5 was deemed acceptable for most participants. Participants expressed that mentor training should include emotional intelligence, communication skills, and the scientific evidence about e-cigarettes. Although monetary incentives were not the main motivating factor for being a peer mentor, they were viewed as a good way to compensate mentors' time. Instagram was considered an appropriate social media platform to deliver a peer-mentored intervention due to its functionality. Participants did not express many privacy concerns about social media-based peer mentoring, but mentioned that boundaries and community agreements should be set to keep relationships professional. CONCLUSIONS This study reflects the needs and preferences of young people for a peer mentoring intervention to complement a social media program to support e-cigarette cessation. The next step will be to establish the feasibility, acceptability, and preliminary efficacy of such a peer mentoring program.
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Affiliation(s)
- Joanne Chen Lyu
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States
| | - Aliyyat Afolabi
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States
| | - Justin S White
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States
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Montasser MA, McKay LK. MOBILE APP AND SOCIAL MEDIA-BASED INTERVENTIONS MAY HAVE A POSITIVE INFLUENCE ON THE BEHAVIOR OF ORTHODONTIC PATIENTS. J Evid Based Dent Pract 2022; 22:101784. [PMID: 36494105 DOI: 10.1016/j.jebdp.2022.101784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION The influence of mobile applications and social media-based interventions in producing behavior change among orthodontic patients: A systematic review and meta-analysis. Al-Moghrabi D, Alkadhimi A, Tsichlaki A, Pandis N, Fleming PS. Am J Orthod Dentofacial Orthop. 2022;161(3):338-354. SOURCE OF FUNDING Deanship of Scientific Research at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. TYPE OF STUDY/DESIGN Systematic review with meta-analysis.
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Affiliation(s)
- Mona A Montasser
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 35516, Mansoura, Egypt
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García-Méndez C, García-Padilla FM, Romero-Martín M, Sosa-Cordobés E, Domínguez-Pérez MDM, Robles-Romero JM. Social networks: A quality tool for health dissemination? JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:355. [PMID: 36618459 PMCID: PMC9818683 DOI: 10.4103/jehp.jehp_355_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/19/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Social networks are integrated in our lives and, amongst other functions, they are a means of dissemination. There are numerous social network accounts dedicated to health that could be used as an educational resource. The aim of this study was to evaluate the quality of accounts dedicated to health in different social networks, assessing their content and didactic and technological effectiveness and accessibility. MATERIALS AND METHODS Observational cross-sectional descriptive study in which an analysis of social networks related to health was carried out from April to June 2021 in Spain. Twenty-eight accounts were analysed using a mixed qualitative-quantitative methodology. Content analysis of the speeches disseminated through the selected accounts was performed. In addition, the quality of the accounts was assessed with the Instrumento de Evaluación de Recursos Educativos Digitales (#IE_RED) (Digital Educational Resources Evaluation Instrument [#IE_RED]). RESULTS Four categories were identified according to the content: student-focused profiles, specific professionals' profiles, current health issues and profiles promoting a healthy lifestyle. In addition, the quality of the accounts obtained a score that indicates they meet the requirements to be validated as a good educational digital resource but could be improved. Instagram social network accounts and those managed by nurses scored significantly higher. CONCLUSIONS The analysed accounts were revealed as a quality tool for health dissemination, with varied content and applicable to teaching. Their use could be applied both to the training of health professionals and to the promotion of the population's health.
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Chai LK, Farletti R, Fathi L, Littlewood R. A Rapid Review of the Impact of Family-Based Digital Interventions for Obesity Prevention and Treatment on Obesity-Related Outcomes in Primary School-Aged Children. Nutrients 2022; 14:nu14224837. [PMID: 36432522 PMCID: PMC9698336 DOI: 10.3390/nu14224837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
Virtual delivery of obesity prevention and treatment programs may be effective for supporting children and families to adopt healthy lifestyle changes while enhancing program accessibility. This rapid review aimed to summarize the impact of family-based digital interventions for childhood obesity prevention and treatment. Four databases were searched up to February 2021 for trials of interactive digital programs aimed to prevent and/or treat obesity in children aged 5-12 years and reported diet, physical activity, sedentary behavior, sleep, or weight-related outcomes in children. A total of 23 publications (from 18 interventions) were included. Behavior change theories were used in 13 interventions with "Social Cognitive Theory" applied most frequently (n = 9). Interventions included websites (n = 11), text messaging (n = 5), video gaming (n = 2), Facebook (n = 3), and/or mobile applications (n = 2). Studies reported changes in body mass index (BMI; n = 11 studies), diet (n = 11), physical activity (n = 10), screen time (n = 6), and/or sleep (n = 1). Significant improvements were reported for diet (n = 5) or physical activity (n = 4). Two of the six interventions were effective in reducing screen time. Digital interventions have shown modest improvements in child BMI and significant effectiveness in diet and physical activity, with emerging evidence supporting the use of social media and video gaming to enhance program delivery.
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Affiliation(s)
- Li Kheng Chai
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD 4064, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Correspondence:
| | - Rebecca Farletti
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD 4064, Australia
| | - Leila Fathi
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Robyn Littlewood
- Health and Wellbeing Queensland, Queensland Government, Brisbane, QLD 4064, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
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Maybery D, Reupert A, Bartholomew C, Cuff R, Duncan Z, McAuliffe C, McLean L, Pettenuzzo L, Swing A, Foster K. An online intervention for 18-25-year-old youth whose parents have a mental illness and/or substance use disorder: A pilot randomized controlled trial. Early Interv Psychiatry 2022; 16:1249-1258. [PMID: 35118795 PMCID: PMC9790290 DOI: 10.1111/eip.13274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/20/2021] [Accepted: 01/18/2022] [Indexed: 12/30/2022]
Abstract
AIM Young adults aged 18-25 whose parents have a mental illness or substance use problem can be vulnerable to multiple difficulties in adulthood. There are, however, few available interventions designed for this group. This study evaluated a 6 week online intervention (mi. spot; mental illness: supported, preventative, online, targeted) specifically designed for this population. The intervention aims to improve mental health and wellbeing. METHODS Forty-one young people, recruited from the community, participated in a two-arm parallel randomized controlled trial where participants were randomized to mi. spot (n = 22) or a wait list control group (n = 19). They were assessed at baseline, immediately post intervention and at six weeks post intervention with measures covering depression, anxiety and stress, wellbeing, coping, general self-efficacy, help seeking and social connectedness. RESULTS Intervention participants reported significantly improved psychological wellbeing, coping, general self-efficacy, and a reduction in anxiety. Participants in the control group reported significant improvements in emotional wellbeing and help seeking and a reduction in self-blame. CONCLUSION This pilot controlled trial supported previous findings and shows preliminary evidence that mi.spot is effective for young adults who grew up with parents who have a mental illness or substance use problem. A large-scale, randomized controlled trial with a diverse group of young people is needed.
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Affiliation(s)
- Darryl Maybery
- School of Rural Health, Monash University, Warragul, Australia, Australia
| | - Andrea Reupert
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | | | - Rose Cuff
- Satellite Foundation, North Melbourne, Australia
| | - Zoe Duncan
- School of Rural Health, Monash University, Warragul, Australia, Australia
| | - Caitlin McAuliffe
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Louise McLean
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Laura Pettenuzzo
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Alice Swing
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Kim Foster
- North Western Mental Health, Melbourne, Victoria, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Melbourne, Australia
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Sun Y, Gao Y, Yu S, Wang A, Ou X, Tao D, Baker JS. Promoting Physical Activity among Workers: A Review of Literature and Future Directions on Developing Theory-Based Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13594. [PMID: 36294174 PMCID: PMC9602512 DOI: 10.3390/ijerph192013594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Insufficient physical activity (PA) has been identified as a leading risk factor for premature and all-cause death, as well as non-communicable diseases. Employees, especially those with low occupational PA, are more vulnerable to physical inactivity, and studies in this population are scarce. However, employees may receive benefits for both health and work productivity from PA. Therefore, well-designed behavior change studies to promote PA in employees are urgently needed, especially during the COVID-19 pandemic. Literature was searched before 30 July 2022, and updated evidence was summarized. This review elaborates on the evidence related to insufficient PA and further provides an overview of theory-based interventions for promoting PA. Evidence indicates that intervention mapping (IM) was a useful tool to develop, implement, and evaluate behavior change interventions. Based on the IM framework, reviewing the theory- and evidence-based change methods and delivery modes, and further identifying the research gaps and limitations of existing interventions could provide promising suggestions and directions for development of well-founded interventions promoting PA among employees. The updated knowledge base for developing future interventions may boost efficacy and provide firm conclusions for researchers in this area.
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Affiliation(s)
- Yan Sun
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China
| | - Siyue Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Aiwei Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- College of Physical Education, Yangzhou University, Yangzhou 225012, China
| | - Xiaoting Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
| | - Dan Tao
- Department of Government and International Studies, Hong Kong Baptist University, Hong Kong 999077, China
| | - Julien S. Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China
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Chan V, Allman-Farinelli M. Young Australian Adults Prefer Video Posts for Dissemination of Nutritional Information over the Social Media Platform Instagram: A Pilot Cross-Sectional Survey. Nutrients 2022; 14:nu14204382. [PMID: 36297066 PMCID: PMC9610946 DOI: 10.3390/nu14204382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/18/2022] Open
Abstract
Growing social media use in young adults may have applications in health promotion. This study aimed to determine the acceptability and feasibility of using Instagram to disseminate nutritional information to young Australians and assess the most preferred post style. A cross-sectional web-based pilot survey was conducted in 18−30-year-olds residing in New South Wales. Eight sets of mock Instagram posts were generated comprising three formats: (i) text/icon, (ii) realistic image, or (iii) video. Respondents (n = 108) were asked to review and rank posts from highest to lowest according to likelihood of engagement, visual preference, motivation to change eating behaviors, and relevancy of information. The Friedman test (Wilcoxon signed-rank test post hoc analysis with Bonferroni correction) was conducted to determine differences between the three post styles. Video style posts were more likely to be engaged with (p < 0.001), visually preferred (p < 0.001), more motivating to change eating behaviors (p < 0.001), and presented the most relevant food and nutrition knowledge (p < 0.001) compared with the other post styles. Most participants reported that Instagram was a suitable platform to share food and nutrition information (96%). The findings of this pilot study can be used to inform a large study that investigates the use of Instagram among a more diverse population and with a greater number of video posts tailored for audience segmentation.
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Affiliation(s)
- Virginia Chan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Correspondence:
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Wallbank G, Haynes A, Tiedemann A, Sherrington C, Grunseit AC. Designing physical activity interventions for women aged 50+: a qualitative study of participant perspectives. BMC Public Health 2022; 22:1855. [PMID: 36195939 PMCID: PMC9531643 DOI: 10.1186/s12889-022-14237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Active Women over 50 trial tested a scalable program for increasing physical activity among women aged 50+. The program included information, activity tracker and email support. This study sought to describe the participant perspectives of the Active Women over 50 program and considerations for designing physical activity interventions for this demographic. METHODS Women who completed the Active Women over 50 trial were purposively recruited for maximum variation in age, employment, carer responsibility, medical conditions and physical activity. Individual semi-structured interviews explored their perspectives on physical activity, Active Women over 50 program components and suggestions for future iterations. Data were thematically analysed. RESULTS Participants' capacity to be physically active was shaped by an interplay of factors. Our analysis generated four main themes relating to physical activity in general and to the program: Age and gender matters, Physical activity is social, Strategising for physical activity and the Self-responsibility discourse. At this midlife stage, physical activity participation was challenged by personal, life-stage and cultural factors, alongside a tension of the self-responsibility discourse which also impacted the program experience. Social factors and finding a suitable strategy for motivation were deemed integral aspects of being active. Future programs could consider facilitation of social networks and accountability, life-stage health information and positive framing to support self-responsibility. CONCLUSION A range of strategies is key to supporting women over 50 to be more physically active due to the variety of circumstances and levels of agency experienced. We offer suggestions that do not need to be resource intensive but could be incorporated into a scaled program.
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Affiliation(s)
- Geraldine Wallbank
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. .,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. .,, Missenden Road, PO Box M179, 2050, Camperdown, NSW, Australia.
| | - Abby Haynes
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Anne C Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Schlicht JA, van Woudenberg TJ, Buijzen M. Arranging the fruit basket: A computational approach towards a better understanding of adolescents' diet-related social media communications. Acta Psychol (Amst) 2022; 230:103738. [PMID: 36113249 DOI: 10.1016/j.actpsy.2022.103738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/05/2022] [Accepted: 09/04/2022] [Indexed: 11/01/2022] Open
Abstract
This study investigated the contents and linguistic styles that adolescents use in their dietary communications on social media. The main aim of the study was to describe adolescents' social media communication practices with regards to diet, in order to better understand dietary social influences and how to effectively intervene in them. The current study made use of an online communication dataset (N = 72,384 messages) of adolescents in primary and secondary school (N = 1038, 9-16 y/o). We analyzed the message content using tailor-made diet- and health-related dictionaries and LDA topic modeling. The linguistic style of the messages was investigated by assessing the sentiment and underlying psychological dimensions. Further, we used multivariate linear regressions to test how each message dimension was related to message liking, which was considered as an indicator of a message's influence potential regarding peers' dietary behaviors. The results confirmed that adolescents show a preference to discuss neutral-to-unhealthy dietary items most often. No association emerged between message content (i.e., message healthiness and topics) and the number of likes that a message received, while messages with more positive sentiment and higher subjectivity received slightly more likes. Also, our findings confirm that visual dietary content is more often liked than textual descriptions alone. The findings indicate that the content and the healthiness of a message does not explain its popularity among adolescents. Rather, the way how diet-related content is formulated (i.e., in a positive and subjective tone) emerged as a more important predictor for message liking.
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Affiliation(s)
- Jonas A Schlicht
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands.
| | - Thabo J van Woudenberg
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands
| | - Moniek Buijzen
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands; Radboud University Nijmegen, the Netherlands
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Dobbie LJ, Tahrani A, Alam U, James J, Wilding J, Cuthbertson DJ. Exercise in Obesity-the Role of Technology in Health Services: Can This Approach Work? Curr Obes Rep 2022; 11:93-106. [PMID: 34791611 PMCID: PMC8597870 DOI: 10.1007/s13679-021-00461-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Physical activity (PA) is an important strategy to prevent and treat obesity. Electronic health (eHealth) interventions, such as wearable activity monitors and smartphone apps, may promote adherence to regular PA and successful weight loss. This review highlights the evidence for eHealth interventions in promoting PA and reducing weight. RECENT FINDINGS Wearables can increase PA and are associated with moderate weight loss in middle/older-aged individuals, with less convincing effects long-term (> 1 year) and in younger people. Data for interventions such as mobile phone applications, SMS, and exergaming are less robust. Investigations of all eHealth interventions are often limited by complex, multi-modality study designs, involving concomitant dietary modification, making the independent contribution of each eHealth intervention on body weight challenging to assess. eHealth interventions may promote PA, thereby contributing to weight loss/weight maintenance; however, further evaluation is required for this approach to be adopted into routine clinical practice.
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Affiliation(s)
- Laurence J. Dobbie
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Abd Tahrani
- Institute of Metabolism and Systems, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Jennifer James
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - John Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Daniel J. Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Buller D, Walkosz B, Henry K, Woodall WG, Pagoto S, Berteletti J, Kinsey A, Divito J, Baker K, Hillhouse J. Promoting Social Distancing and COVID-19 Vaccine Intentions to Mothers: Randomized Comparison of Information Sources in Social Media Messages. JMIR INFODEMIOLOGY 2022; 2:e36210. [PMID: 36039372 PMCID: PMC9400429 DOI: 10.2196/36210] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/28/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022]
Abstract
Background Social media disseminated information and spread misinformation during the COVID-19 pandemic that affected prevention measures, including social distancing and vaccine acceptance. Objective In this study, we aimed to test the effect of a series of social media posts promoting COVID-19 nonpharmaceutical interventions (NPIs) and vaccine intentions and compare effects among 3 common types of information sources: government agency, near-peer parents, and news media. Methods A sample of mothers of teen daughters (N=303) recruited from a prior trial were enrolled in a 3 (information source) × 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate the effects of information sources in a social media campaign addressing NPIs (ie, social distancing), COVID-19 vaccinations, media literacy, and mother–daughter communication about COVID-19. Mothers received 1 social media post per day in 3 randomly assigned Facebook private groups, Monday-Friday, covering all 4 topics each week, plus 1 additional post on a positive nonpandemic topic to promote engagement. Posts in the 3 groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Mothers reported on social distancing behavior and COVID-19 vaccine intentions for self and daughter, theoretic mediators, and covariates in baseline and 3-, 6-, and 9-week postrandomization assessments. Views, reactions, and comments related to each post were counted to measure engagement with the messages. Results Nearly all mothers (n=298, 98.3%) remained in the Facebook private groups throughout the 9-week trial period, and follow-up rates were high (n=276, 91.1%, completed the 3-week posttest; n=273, 90.1%, completed the 6-week posttest; n=275, 90.8%, completed the 9-week posttest; and n=244, 80.5%, completed all assessments). In intent-to-treat analyses, social distancing behavior by mothers (b=–0.10, 95% CI –0.12 to –0.08, P<.001) and daughters (b=–0.10, 95% CI –0.18 to –0.03, P<.001) decreased over time but vaccine intentions increased (mothers: b=0.34, 95% CI 0.19-0.49, P<.001; daughters: b=0.17, 95% CI 0.04-0.29, P=.01). Decrease in social distancing by daughters was greater in the near-peer source group (b=–0.04, 95% CI –0.07 to 0.00, P=.03) and lesser in the government agency group (b=0.05, 95% CI 0.02-0.09, P=.003). The higher perceived credibility of the assigned information source increased social distancing (mothers: b=0.29, 95% CI 0.09-0.49, P<.01; daughters: b=0.31, 95% CI 0.11-0.51, P<.01) and vaccine intentions (mothers: b=4.18, 95% CI 1.83-6.53, P<.001; daughters: b=3.36, 95% CI 1.67-5.04, P<.001). Mothers’ intentions to vaccinate self may have increased when they considered the near-peer source to be not credible (b=–0.50, 95% CI –0.99 to –0.01, P=.05). Conclusions Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions. When promoting COVID-19 prevention, campaign planners may be more effective when selecting information sources that audiences consider credible, as no source was more credible in general. Trial Registration ClinicalTrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807
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Affiliation(s)
| | | | - Kimberly Henry
- Department of Psychology Colorado State University Fort Collins, CO United States
| | | | - Sherry Pagoto
- Department of Allied Health Sciences University of Connecticut Storrs, CT United States
| | | | | | - Joseph Divito
- Department of Allied Health Sciences University of Connecticut Storrs, CT United States
| | - Katie Baker
- Department of Community and Behavioral Health East Tennessee State University Johnson City, TN United States
| | - Joel Hillhouse
- Department of Community and Behavioral Health East Tennessee State University Johnson City, TN United States
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Dvorsky MR, Breaux R, Langberg JM, Becker SP. Adolescents with ADHD are at increased risk for COVID-19 vaccine hesitancy. J Psychiatr Res 2022; 152:25-30. [PMID: 35714550 PMCID: PMC9179933 DOI: 10.1016/j.jpsychires.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/12/2022]
Abstract
Identifying factors that influence adolescent intentions for COVID-19 vaccination is essential for developing strategic interventions to increase uptake, particularly in subgroups of at-risk adolescents. Attention-deficit/hyperactivity disorder (ADHD) in adolescence is characterized by difficulties regulating attention and behavior, social impairment, and impulsive risk-taking behaviors, which may impact vaccine hesitancy and vaccine uptake. This study examined hesitancy toward COVID-19 vaccines among adolescents with and without ADHD, and explored how ADHD status interacted with malleable social mechanisms and other social determinants of health in predicting vaccine hesitancy. Participants were 196 U.S. adolescents (44.4% male), 45.6% diagnosed with ADHD. Adolescents reported their confidence and willingness toward COVID-19 vaccines from March to May 2021. Adolescents with ADHD reported greater hesitancy and less confidence in COVID-19 vaccine safety compared to adolescents without ADHD (p < .01). Only 61.8% of adolescents with ADHD reported vaccine acceptance, compared to 81.3% of adolescents without ADHD. For all adolescents, those who identified as Black or Latinx and with lower family income had greater hesitancy and reduced confidence, whereas greater COVID-19 concerns, media use, and perceived negative impact on relationships was associated with greater vaccination willingness. Social contextual processes significantly interacted with ADHD status such that for adolescents without ADHD, concerns about COVID-19 were associated with increased confidence in vaccine safety. Being noncompliant with social distancing guidelines was associated with greater vaccine hesitancy, only for adolescents with ADHD. A concerted effort is needed to increase trust, confidence, and social relevance among adolescents, especially those with ADHD and from lower socio-economic backgrounds.
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Affiliation(s)
- Melissa R. Dvorsky
- Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA,Department of Psychiatry & Behavioral Sciences, Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA,Corresponding author. Center for Translational Research, Division of Psychology and Behavioral Health, Children's National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Rosanna Breaux
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Xu R, Divito J, Bannor R, Schroeder M, Pagoto S. Predicting Participant Engagement in a Social Media-Delivered Lifestyle Intervention Using Microlevel Conversational Data: Secondary Analysis of Data From a Pilot Randomized Controlled Trial. JMIR Form Res 2022; 6:e38068. [PMID: 35900824 PMCID: PMC9377444 DOI: 10.2196/38068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Social media-delivered lifestyle interventions have shown promising outcomes, often generating modest but significant weight loss. Participant engagement appears to be an important predictor of weight loss outcomes; however, engagement generally declines over time and is highly variable both within and across studies. Research on factors that influence participant engagement remains scant in the context of social media-delivered lifestyle interventions. OBJECTIVE This study aimed to identify predictors of participant engagement from the content generated during a social media-delivered lifestyle intervention, including characteristics of the posts, the conversation that followed the post, and participants' previous engagement patterns. METHODS We performed secondary analyses using data from a pilot randomized trial that delivered 2 lifestyle interventions via Facebook. We analyzed 80 participants' engagement data over a 16-week intervention period and linked them to predictors, including characteristics of the posts, conversations that followed the post, and participants' previous engagement, using a mixed-effects model. We also performed machine learning-based classification to confirm the importance of the significant predictors previously identified and explore how well these measures can predict whether participants will engage with a specific post. RESULTS The probability of participants' engagement with each post decreased by 0.28% each week (P<.001; 95% CI 0.16%-0.4%). The probability of participants engaging with posts generated by interventionists was 6.3% (P<.001; 95% CI 5.1%-7.5%) higher than posts generated by other participants. Participants also had a 6.5% (P<.001; 95% CI 4.9%-8.1%) and 6.1% (P<.001; 95% CI 4.1%-8.1%) higher probability of engaging with posts that directly mentioned weight and goals, respectively, than other types of posts. Participants were 44.8% (P<.001; 95% CI 42.8%-46.9%) and 46% (P<.001; 95% CI 44.1%-48.0%) more likely to engage with a post when they were replied to by other participants and by interventionists, respectively. A 1 SD decrease in the sentiment of the conversation on a specific post was associated with a 5.4% (P<.001; 95% CI 4.9%-5.9%) increase in the probability of participants' subsequent engagement with the post. Participants' engagement in previous posts was also a predictor of engagement in subsequent posts (P<.001; 95% CI 0.74%-0.79%). Moreover, using a machine learning approach, we confirmed the importance of the predictors previously identified and achieved an accuracy of 90.9% in terms of predicting participants' engagement using a balanced testing sample with 1600 observations. CONCLUSIONS Findings revealed several predictors of engagement derived from the content generated by interventionists and other participants. Results have implications for increasing engagement in asynchronous, remotely delivered lifestyle interventions, which could improve outcomes. Our results also point to the potential of data science and natural language processing to analyze microlevel conversational data and identify factors influencing participant engagement. Future studies should validate these results in larger trials. TRIAL REGISTRATION ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Joseph Divito
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Matthew Schroeder
- Center for Aging Research, Indiana University, Indianapolis, IN, United States
| | - Sherry Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
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