Is Social Media a New Type of Social Support? Social Media Use in Spain during the COVID-19 Pandemic: A Mixed Methods Study

Our lifestyles are back to 'normal', but is our mental health? Longitudinal assessment of psychological distress during the COVID-19 pandemic among Spanish adults: April 2021 to August 2022

The COVID-19 pandemic had a detrimental effect on mental health since its start in 2020 and current data on mental health is limited. This study provides recent longitudinal data on psychological distress among a country-wide sample of adults. We recruited and surveyed 1,956 adults in Spain in April 2021 and August 2022 on sociodemographic- and pandemic-related psychological distress using the General Distress 21-item version of the Depression, Anxiety, and Stress Scale (DASS). Paired sampled t-tests assessed DASS scores by sex from April 2021 to August 2022; and one-way ANOVAs assessed DASS scores across sociodemographic characteristics. Results showed that psychological distress slightly improved across the total sample from April 2021 to August 2022; though females, young adults, students, and individuals with lower income experienced more psychological distress. Increases in severe stress scores were found particularly among men. Our data provides an overview of the psychological distress of Spanish adults 2.5 years into the pandemic and provides novel evidence that though life has resumed a sense of normalcy after the COVID-19 pandemic, the mental health of key populations (e.g., females, young adults, students, low-income) is still suffering and further intervention and resources are needed.

Examining the growth in willingness to pay for digital wellbeing services on social media: A comparative analysis

In recent years, there has been a growing need for social media platforms to offer services that preserve and promote users' digital wellbeing, including better protection of personal data and balanced technology usage. However, the current business model of social media is often seen as in conflict with users' digital wellbeing. In 2020, a study investigated users' willingness to pay monetary fees for social media digital wellbeing services. In the present work, we replicated this study in Q4 of 2022, aiming to explore any changes in interest and willingness to pay for these services. In addition, we extended the replication by conducting qualitative analysis on participants' comments to gain deeper insight and identify reasons for payment and reasons for rejecting to pay. Data were collected from 262 participants through an online questionnaire. The survey focused on four services: better data protection, less use of data for marketing, aiding users in controlling their prolonged usage, and reducing fake news and radicalisation on social media. The results showed that the willingness to pay for these services was significantly higher in 2022 compared to the results published in 2020. Participants expressed concerns about the feasibility and fairness of the alternative business model, which requires users to pay for safety and support. Our findings suggest a growing interest in digital wellbeing services, emphasizing the need for social media platforms to assess the feasibility of alternative business models, identify user segments, and take measures to enhance consumers' trust, accordingly.

The impact of social media use on psychiatric symptoms and well-being of children and adolescents in the Post-COVID-19 era: a four-year longitudinal study

This longitudinal study examined the long-term effects of the COVID-19 pandemic on social media use and its impact on psychiatric symptoms and well-being of 3,697 Israeli children and adolescents aged 8 to 14. Data were collected from October 2019 to June 2023, covering four school years and five measurement points prior to, throughout and post- COVID-19. Social media usage, psychiatric symptoms (depression, anxiety, somatization, and general distress), as well as subjective well-being (positive and negative emotions, and life satisfaction) were assessed. The analysis also probed the extent to which social support and extracurricular activities moderated the associations between social media use and mental health outcomes. The results of the growth mixed-effects models indicated a significant increase in social media use and psychiatric symptoms, and a significant decrease in subjective well-being over time. Greater social media use was related to more psychiatric symptoms and negative emotions, but also to more positive emotions and life satisfaction. Social support buffered the negative effects of excessive social media use on mental health, whereas extracurricular activities increased positive emotions, but also psychiatric symptoms related to social media use. These findings highlight the need for targeted interventions to regulate social media usage, given its lasting consequences on the mental health of children and adolescents in the wake of the COVID-19 pandemic.

The impact of COVID-19 on the peer relationships of adolescents around the world: A rapid systematic review

The main objective of this rapid systematic review was to examine how the COVID-19 pandemic impacted peer relationships for adolescents (10-25 years of age) around the globe. We focused on four indices of peer relationships: (1) loneliness, (2) social connectedness, (3) social support, and (4) social media use. In addition, we examined gender and age differences. Four databases (APA PsychInfo, PubMed, Scopus, and Web of Science) were searched for articles published from January 2020 to November 2022. A total of 96 studies (cross-sectional: n = 66, longitudinal: n = 30, quantitative: n = 67, qualitative: n = 12, mixed-methods: n = 17) met our inclusion criteria (empirical observational studies with data on at least one of the indices of interest, cross-sectional data on COVID-19-related experiences or longitudinal data collected during the pandemic, age range of 10-25 years, typically developing adolescents). We extracted data and conducted a narrative synthesis. Findings suggest that COVID-19 disruptions negatively impacted peer relationships for youth. Most studies reported either an increase in loneliness over the course of the pandemic or a positive association between loneliness and COVID-19-related experiences. Similar findings were observed for increased social media use as a means of continued communication and connection. Fewer studies focused on social support but those that did reported a decrease or negative association with COVID-19-related experiences. Lastly, findings suggest a mixed impact on social connectedness, which might be due to the strengthening of closer ties and weakening of more distant relationships. Results for gender differences were mixed, and a systematic comparison of differences across ages was not possible. The heterogeneity in measures of COVID-19-related experiences as well as timing of data collection prevented a more nuanced examination of short and more long-term impacts.

Assessing Electronic Health Literacy in Individuals With the Post-COVID-19 Condition Using the German Revised eHealth Literacy Scale: Validation Study

BACKGROUND

The eHealth Literacy Scale (eHEALS) is a widely used instrument for measuring eHealth literacy (eHL). However, little is known so far about whether the instrument is valid for the assessment of eHL in persons who are affected by the post-COVID-19 condition. This is particularly important as people with the post-COVID-19 condition are frequently affected by false information from the internet.

OBJECTIVE

The objective of our study was to evaluate the validity and reliability of the German Revised eHealth Literacy Scale (GR-eHEALS) in individuals with the post-COVID-19 condition.

METHODS

A cross-sectional study was conducted from January to May 2022. The self-assessment survey consisted of the GR-eHEALS, health status- and internet use-related variables, sociodemographic data, and (post)-COVID-19-related medical data. Confirmatory factor analysis (CFA), correlational analyses, and tests of measurement invariance were deployed.

RESULTS

In total, 330 participants were included in the statistical analyses. CFA revealed that the 2-factor model reached an excellent model fit (comparative fit index=1.00, Tucker-Lewis index=0.99, root mean square error of approximation=0.036, standardized root mean square residual=0.038). Convergent validity was confirmed by significant positive correlations between eHL and knowledge of internet-based health promotion programs, experience in using these programs, and the duration of private internet use. In addition, a significantly negative relationship of eHL with internet anxiety supported convergent validity. Further, significant relationships of eHL with mental health status and internal health locus of control confirmed the criterion validity of the instrument. However, relationships of eHL with physical health status and quality of life could not be confirmed. The 2-factor model was fully measurement invariant regarding gender. Regarding age and educational level, partial measurement invariance was confirmed. The subscales as well as the overall GR-eHEALS reached good-to-excellent reliability (Cronbach α≥.86).

CONCLUSIONS

The GR-eHEALS is a reliable and largely valid instrument for assessing eHL in individuals with the post-COVID-19 condition. Measurement invariance regarding gender was fully confirmed and allows the interpretation of group differences. Regarding age and educational level, group differences should be interpreted with caution. Given the high likelihood that individuals with the post-COVID-19 condition will be confronted with misinformation on the Internet, eHL is a core competency that is highly relevant in this context, in both research and clinical practice. Therefore, future research should also explore alternative instruments to capture eHL to overcome shortcomings in the validity of the GR-eHEALS.

Feasibility of a family-oriented mHealth intervention for Chinese Americans with type 2 diabetes: A pilot randomized control trial

OBJECTIVES

To test the feasibility, acceptability, and potential efficacy of a mHealth intervention tailored for Chinese immigrant families with type 2 diabetes (T2D).

METHODS

We conducted a pilot randomized controlled trial (RCT) with baseline, 3-, and 6-month measurements. Participating dyads, T2D patients and families/friends from NYC, were randomized into the intervention group (n = 11) or the wait-list control group (n = 12). Intervention includes 24 videos covering T2D self-management, behavioral techniques, and family-oriented sessions. Feasibility and acceptability were measured respectively by the retention rate and video watch rate, and a satisfaction survey. Patients' HbA1c, weight, and self-management were also assessed to test potential efficacy.

RESULTS

Most T2D patients (n = 23; mean age 56.2±9.4 years; 52.2% male) and families/friends (n = 23, mean age 54.6±11.2 years; 52.2% female) had high school education or less (69.6% and 69.6%), annual household income < $25,000 (65.2% and 52.2%), and limited English proficiency (95.7% and 95.7%). The retention rates were not significantly different between the intervention and the control groups for both the patients (90.91% vs 83.3%, p = 0.589); and their families/friends (3-month: 90.9% vs 75%, p = 0.313; 6-month: 90.9% vs 83.3%, p = 0.589). The mean video watch rate was 76.8% (7%). T2D patients and families/friends rated satisfaction as 9.4 and 10 out of 10, respectively. Despite no between-group differences, the intervention group had significantly lower HbA1c (p = 0.014) and better self-management (p = 0.009), and lost 12 lbs. on average at 6 months (p = 0.079), compared to their baseline levels.

CONCLUSIONS

A culturally-tailored, family-based mHealth intervention is feasible and acceptable among low-income, limited English-proficient Chinese families with T2D in NYC. Significant changes in HbA1c and self-management within the intervention group indicate this intervention may have potential efficacy. Given the small sample size of this study, a future RCT with adequate power is needed to test efficacy.

Social media consumption and depressive symptoms during the COVID-19 lockdown: the mediating effect of physical activity

Introduction

Social media platforms played a critical role during the COVID-19 pandemic. This study aimed to explore: (1) the changes in social media consumption patterns, physical activity levels/sedentary behavior, and depressive symptoms, and (2) how the changes in social media consumption patterns predict the changes in depressive symptoms while investigating the mediating role of changes in physical activity levels/sedentary behavior between before, and after the COVID-19 lockdown among U.S. adults with different age clusters.

Methods

A total of 695 U.S. participants completed an online questionnaire via MTurk, and participants were asked to recall their social media consumption patterns, physical activity/sedentary behavior, depressive symptoms in January and May of 2020 while covariates included non-physical activity health behavior including diet quality, alcohol consumption, smoking, and sleep quality.

Results

The results of Bayesian significance testing of changes showed that the older participants tended to spend more time with content-focused social media platforms during the lockdown. While significantly increased sitting time was reported by all age clusters, no significant changes were found in activity levels. Additionally, the middle-aged and older participants reported significantly higher depressive symptoms. The findings of a multigroup structural analysis showed the significant mediating effect of moderate-to-vigorous physical activity on the relationship between changes in social media consumption and depressive symptoms.

Discussion

This study highlights the need for targeting specific social media platforms for older adults and the importance of moderate-to-vigorous physical activity to alleviate the mental health issues resulting from social media consumption. The result of this study also highlights the need for sport-based intervention programs in the future and the need for more social media campaigns at the institution/organization levels established by public health stakeholders and policy makers to promote physical activity and maximize population perception and reach during the pandemic.

Diagnosis Disclosure and Peer-to-Peer Information Seeking Among COVID-19-Infected Social Media Users: Survey of US-Based Adults

BACKGROUND

Research examining online health communities suggests that individuals affected by chronic health conditions can obtain valuable information and social support through participation in peer-to-peer web-based information exchanges, including information sharing and seeking behaviors. The risks and rewards of these same behaviors in the case of acute illnesses, such as COVID-19, are less well understood, though there is reason to believe that individuals with COVID-19 and other acute illnesses may accrue similar benefits.

OBJECTIVE

This study examines the propensity of American adults to disclose and discuss their COVID-19 diagnosis and symptoms on social media while actively infected with the SARS-CoV-2 virus, as well as to engage in peer-to-peer information seeking in order to better understand the illness that they are experiencing. Additionally, this study seeks to identify the motivations for these behaviors as well as their subsequent impacts on perceived social connectedness and health anxiety in patients with COVID-19.

METHODS

We conducted a representative survey of 2500 US-based adults using a sample purchased through an industry-leading market research provider. Participants were selected through a stratified quota sampling approach to ensure a representative sample of the US population. Balanced quotas were determined (by region of the country) for gender, age, race, ethnicity, and political affiliation. Responses were analyzed from 946 participants who reported having an active social media account and testing positive for COVID-19 at least once since the start of the pandemic.

RESULTS

The results show that only a small portion of social media users (166/946, 18%) chose to disclose and discuss their COVID-19 diagnosis while infected with the virus. However, among those who did, an overwhelming majority (206/251, 82%) said that doing so helped them feel more connected and supported while infected with the virus. A larger percentage of the 946 respondents (n=319, 34%) engaged in peer-to-peer information seeking while infected with COVID-19. Among those who did, a large majority (301/319, 94%) said that doing so was "helpful," but more than one-third (115/319, 36%) said that reading about other people's experiences made them "more worried" about having COVID-19, while 33% (108/319) said that it made them "less worried." Illness severity and political affiliation were significant predictors of both information sharing and seeking.

CONCLUSIONS

The findings suggest that the benefits (and risks) associated with online health communities are germane to patients with acute illnesses such as COVID-19. It is recommended that public health officials and health care providers take a proactive approach to cultivating professionally moderated forums supporting peer-to-peer engagement during future outbreaks of COVID-19 and other acute illnesses in order to improve patient outcomes and promote social support and connectedness among infected patients.

The Role of Social Media in Building Pandemic Resilience in an Urban Community: A Qualitative Case Study

This paper explores the influence of social media in fostering resilience within an urban spatial context, specifically in Bangalore, India, during the COVID-19 lockdown, a period marked by a surge in digital communication due to movement restrictions. To control the rapid spread of the virus, over 1.38 billion people were given stay-at-home orders by the government of India during the onset of the pandemic. The restrictions in movement forced individuals to shift to online modes of connection and communication. As the field of digital epidemiology, that is, the use of digital tools and data to understand and improve health took center stage during the pandemic, the focus shifted towards the social media landscape, which is often associated with its negative aspects, such as misinformation. However, this paper delves into social media's potential to build resilience on a local scale, particularly given its increased usage during the pandemic. Through in-depth online interviews with eight urban residents, we conducted a thematic analysis to understand social media's role during the lockdown. Results indicate that social media facilitated effective information exchange and fostered a sense of community. Furthermore, it engendered an environment conducive to prosocial behavior, a known resilience amplifier. We also highlight the importance of baseline context regarding the users directly engaged in social media data generation with respect to digital epidemiology analytics tools for large-scale social media data and the need for qualitative input feeding into their design. Our study highlights the need for a balanced perspective on social media use in times of crisis, recognizing its potential to boost community resilience in an urban setting, and further enriching digital epidemiology approaches.

Human behavior in the time of COVID-19: Learning from big data

Since the World Health Organization (WHO) characterized COVID-19 as a pandemic in March 2020, there have been over 600 million confirmed cases of COVID-19 and more than six million deaths as of October 2022. The relationship between the COVID-19 pandemic and human behavior is complicated. On one hand, human behavior is found to shape the spread of the disease. On the other hand, the pandemic has impacted and even changed human behavior in almost every aspect. To provide a holistic understanding of the complex interplay between human behavior and the COVID-19 pandemic, researchers have been employing big data techniques such as natural language processing, computer vision, audio signal processing, frequent pattern mining, and machine learning. In this study, we present an overview of the existing studies on using big data techniques to study human behavior in the time of the COVID-19 pandemic. In particular, we categorize these studies into three groups-using big data to measure, model, and leverage human behavior, respectively. The related tasks, data, and methods are summarized accordingly. To provide more insights into how to fight the COVID-19 pandemic and future global catastrophes, we further discuss challenges and potential opportunities.

Associations between Lifestyle Changes, Risk Perception and Anxiety during COVID-19 Lockdowns: A Case Study in Xi'an

The outbreak of COVID-19 dramatically changed individuals' lifestyles, which in turn triggered psychological stress and anxiety. Many previous studies have discussed the relationships between lifestyle changes and anxiety and risk perception and anxiety independently. However, few papers have discussed these factors in a comprehensive and systematic manner. We established a six-dimensional system to assess changes in individuals' lifestyles, which include dietary habits, physical activity (PA), sleep, screen time, smoking and alcohol consumption, and interaction with neighbors. Then, we collected information relating to socio-demographics, lifestyle changes, risk perception, and anxiety, and discussed their associations using multilinear and stepwise logistic regressions. The results show that not all lifestyle changes had an influence on anxiety. Changes in PA and interaction with neighbors were not significantly associated with anxiety. Risk perception was found to be inversely related to anxiety. Changes in dietary habits, family harmony, and net income were negatively related to anxiety among the group with higher risk perception. As individuals perceived a higher severity of COVID-19, the impact of their financial status on anxiety increased. These findings provide a valuable resource for local governments seeking to refine their pandemic strategies by including approaches such as advocating healthy lifestyles and stabilizing the job market to improve individuals' mental health during lockdowns.

Online Food Security Discussion Before and During the COVID-19 Pandemic in Native Hawaiian and Pacific Islander Community Groups and Organizations: Content Analysis of Facebook Posts

Background

The Native Hawaiian and Pacific Islander (NHPI) population experiences disproportionately higher rates of food insecurity, which is a risk factor for cardiometabolic diseases such as cardiovascular disease, type 2 diabetes, obesity, and hypertension, when compared to white individuals. Novel and effective approaches that address food insecurity are needed for the NHPI population, particularly in areas of the continental United States, which is a popular migration area for many NHPI families. Social media may serve as an opportune setting to reduce food insecurity and thus the risk factors for cardiometabolic diseases among NHPI people; however, it is unclear if and how food insecurity is discussed in online communities targeting NHPI individuals.

Objective

The objective of this study was to characterize the quantity, nature, and audience engagement of messages related to food insecurity posted online in community groups and organizations that target NHPI audiences.

Methods

Publicly accessible Facebook pages and groups focused on serving NHPI community members living in the states of Washington or Oregon served as the data source. Facebook posts between March and June 2019 (before the COVID-19 pandemic) and from March to June 2020 (during the COVID-19 pandemic) that were related to food security were identified using a set of 36 related keywords. Data on the post and any user engagement (ie, comments, shares, or digital reactions) were extracted for all relevant posts. A content analytical approach was used to identify and quantify the nature of the identified posts and any related comments. The codes resulting from the content analysis were described and compared by year, page type, and engagement.

Results

Of the 1314 nonduplicated posts in the 7 relevant Facebook groups and pages, 88 were related to food security (8 in 2019 and 80 in 2020). The nature of posts was broadly classified into literature-based codes, food assistance (the most common), perspectives of food insecurity, community gratitude and support, and macrolevel contexts. Among the 88 posts, 74% (n=65) had some form of engagement, and posts reflecting community gratitude and support or culture had more engagement than others (mean 19.9, 95% CI 11.2-28.5 vs mean 6.1, 95% CI 1.7-10.4; and mean 26.8, 95% CI 12.7-40.9 vs mean 5.3, 95% CI 3.0-7.7, respectively).

Conclusions

Food security–related posts in publicly accessible Facebook groups targeting NHPI individuals living in Washington and Oregon largely focused on food assistance, although cultural values of gratitude, maintaining NHPI culture, and supporting children were also reflected. Future work should capitalize on social media as a potential avenue to reach a unique cultural group in the United States experiencing inequitably high rates of food insecurity and risk of cardiometabolic diseases.

Role of COVID-19 Anxiety and Community Risk Factors on Physical Distancing Practice

Existing studies have focused primarily on self-oriented anxiety (i.e., anxiety over one’s infection) in the pandemic context, and the role of community risk is largely ignored. This study addressed these gaps by examining (a) self-oriented anxiety and two forms of others-oriented anxiety (i.e., anxiety concerning others’ health and societal problems), (b) the associations between all these forms of anxiety and physical distancing practice during the COVID-19 pandemic, and (c) the hypothesized moderating role of community risk factors. The participants were 703 U.S. community-dwelling adults who completed an online survey. Geo-identifier data were extracted to identify the number of confirmed COVID-19 cases and four social vulnerability indexes for the county in which each participant resided. Both forms of others-oriented anxiety were positively associated with physical distancing adoption, and the association was stronger among the participants residing in lower-risk communities (i.e., fewer confirmed COVID-19 cases, higher socioeconomic status, and better housing conditions). The study’s novel findings reveal the protective role of anxiety, particularly anxiety concerning others’ well-being, in encouraging people to adopt physical distancing during a pandemic. However, the protective role of anxiety is contingent upon certain community risk factors. Anxiety is more beneficial to residents of low- rather than high-risk communities.