Understanding the effects of message cues on COVID-19 information sharing on Twitter

Promoting Public Engagement in Palliative and End-of-Life Care Discussions on Chinese Social Media: Model Development and Analysis

BACKGROUND

In Chinese traditional culture, discussions surrounding death are often considered taboo, leading to a poor quality of death, and limited public awareness and knowledge about palliative and end-of-life care (PEoLC). However, the increasing prevalence of social media in health communication in China presents an opportunity to promote and educate the public about PEoLC through online discussions.

OBJECTIVE

This study aimed to examine the factors influencing public engagement in PEoLC discussions on a Chinese social media platform and develop practice recommendations to promote such engagement.

METHODS

We gathered 30,811 PEoLC-related posts on Weibo, the largest social media platform in China. Guided by the elaboration likelihood model, our study examined factors across 4 dimensions: content theme, mood, information richness, and source credibility. Content theme was examined using thematic analysis, while sentiment analysis was used to determine the mood of the posts. The impact of potential factors on post engagement was quantified using negative binomial regression.

RESULTS

Organizational accounts exhibited lower engagement compared to individual accounts (incidence rate ratio [IRR]<1; P<.001), suggesting an underuse of organizational accounts in advocating for PEoLC on Weibo. Posts centered on PEoLC-related entertainment (films, television shows, and books; IRR=1.37; P<.001) or controversial social news (IRR=1.64; P<.001) garnered more engagement, primarily published by individual accounts. An interaction effect was observed between content theme and post mood, with posts featuring more negative sentiment generally attracting higher public engagement, except for educational-related posts (IRR=2.68; P<.001).

CONCLUSIONS

Overall, organizations faced challenges in capturing public attention and involving the public when promoting PEoLC on Chinese social media platforms. It is imperative to move beyond a traditional mode to incorporate cultural elements of social media, such as engaging influencers, leveraging entertainment content and social news, or using visual elements, which can serve as effective catalysts in attracting public attention. The strategies developed in this study are particularly pertinent to nonprofit organizations and academics aiming to use social media for PEoLC campaigns, fundraising efforts, or research dissemination.

Fighting Fire or Fighting War: Examining the Framing Effects of COVID-19 Metaphors

Metaphorical language describing the COVID-19 pandemic as a war has been pervasive in public discourse (e.g. "the pandemic is a war," "the virus is an enemy," and "the vaccine is a weapon"). This study employs an online survey experiment (N = 551 U.S. adults) to examine the impact of war metaphors compared to non-metaphorical literal frames and fire metaphors (e.g. "the pandemic is a wildfire"). War metaphors exhibited little advantage over literal frames across a variety of desirable outcomes (i.e. the adoption of pro-health behaviors against COVID-19, perceived solidarity and collective responsibility to curb the pandemic, and intentions to discuss and share the health news with others). However, this study revealed some benefits of war metaphors over fire metaphors. Compared with fire metaphors, health news featuring war metaphors increased both positive emotions and perceived threats of COVID-19, which in turn promoted pro-health behaviors against COVID-19 and perceived solidarity to cope with the public health crisis. Moreover, positive emotions in response to war metaphors also indirectly encouraged the retransmission of science-based COVID-19 health news. This study thus showcased the benefits and limitations of war metaphors and revealed the mediating roles of perceived threats and positive emotions in explaining war metaphorical framing effects. Implications of using war and fire metaphors for communicating about public health crises are also discussed.

Understanding user engagement in mobile health applications from a privacy management perspective

Mobile health applications (mHealth apps) have surged in popularity for their role in promoting knowledge exchange and providing emotional support among health consumers. However, this enhanced social connectivity via these apps has led to an escalation in privacy breaches, potentially hindering user engagement. Drawing upon the communication privacy management theory, this study proposes a moderated mediation model to link social privacy concerns to user engagement in mHealth apps. An online survey involving 1149 mHealth app users was conducted in China to empirically validate the proposed model. Results indicated that social privacy concerns were negatively related to user engagement in mHealth apps, and perceived privacy of the app partially mediated this relationship. Moreover, perceived control positively moderated the indirect relationship between social privacy concerns and user engagement via perceived privacy. Specifically, the negative impact of social privacy concerns on perceived privacy was mitigated for users who reported higher levels of perceived control, indicating that when users feel more in control of their personal data, they are less affected by concerns over social privacy. Theoretically, this study has the potential to help scholars understand user engagement in mHealth apps from a privacy management perspective. Practically, the results of this study could assist mobile app providers and health professionals in devising evidence-based strategies to enhance social engagement and promote effective and sustainable use of mHealth apps among health consumers.

Understanding Social Media Information Sharing in Individuals with Depression: Insights from the Elaboration Likelihood Model and Schema Activation Theory

Purpose

How individuals engage with social media can significantly impact their psychological well-being. This study examines the impact of social media interactions on mental health, grounded in the frameworks of the Elaboration Likelihood Model and Schema Activation Theory. It aims to uncover behavioral differences in information sharing between the general population and individuals with depression, while also elucidating the psychological mechanisms underlying these disparities.

Methods

A pre-experiment (N=30) and three experiments (Experiment 1a N=200, Experiment 1b N=180, Experiment 2 N=128) were executed online. These experiments investigated the joint effects of information quality, content valence, self-referential processing, and depression level on the intention to share information. The research design incorporated within-subject and between-subject methods, utilizing SPSS and SPSS Process to conduct independent sample t-tests, two-factor ANOVA analyses, mediation analyses, and moderated mediation analyses to test our hypotheses.

Results

Information quality and content valence significantly influence sharing intention. In scenarios involving low-quality information, individuals with depression are more inclined to share negative emotional content compared to the general population, and this tendency intensifies with the severity of depression. Moreover, self-referential processing acts as a mediator between emotional content and intention to share, yet this mediation effect weakens as the severity of depression rises.

Conclusion

Our study highlights the importance of promoting viewpoint diversity and breaking the echo chamber effect in social media to improve the mental health of individuals with depression. To achieve this goal, tailoring emotional content on social media could be a practical starting point for practice.

Social Media Health Promotion and Audience Engagement: The Roles of Information Dissemination, Organization-Audience Interaction, and Action Confidence Building

Social media have become an important platform for health promotion. Based on the Information-Community-Action Framework, we conducted a content analysis of 1,481 Facebook postings by Singapore's Health Promotion Board. Results showed that organizational information and health benefit information dissemination were positively associated with online audience engagement. Also, organization-audience interaction had a positive relationship with online audience engagement. In addition, messages that help build confidence for health behavior change increased online audience engagement. In addition to these main effects, organization-audience interaction also played a moderating role that strengthened the effects of information dissemination and action confidence building on online audience engagement. This study offers important theoretical contributions to the Information-Community-Action Framework and has practical implications for enhancing the effectiveness of health promotion in this digital era.

Exploring how health-related advertising interference contributes to the development of cyberchondria: A stressor-strain-outcome approach

Objectives

Cyberchondria is increasingly recognized as the dark side of digital health, given the pervasive use of the internet as a main source of health information in people's daily lives. While previous studies have identified many factors contributing to cyberchondria, there is a dearth of research on the impact of health-related advertisements. Therefore, this study adopts the stressor-strain-outcome (SSO) model to investigate how health-related advertising interference is directly and indirectly related to cyberchondria.

Methods

To empirically validate the proposed research model, we conducted an online survey with 437 internet users with medical information seeking experience in China. Structural equation modeling (SEM) was employed to analyze the survey data.

Results

Our findings revealed a positive, direct association between health-related advertising interference and cyberchondria. Meanwhile, advertising interference was positively related to both information overload and information irrelevance, with the former further predicting cyberchondria. Moreover, doctor-patient communication weakened the positive effect of information overload on cyberchondria.

Conclusions

The study not only theoretically contributes to the literature by theorizing the relationship between health-related advertising interference and cyberchondria but also practically underlines the pivotal role of effective doctor-patient communication in reducing the development of cyberchondria.

How does social presence influence public crisis information sharing intention? Situational pressure perspective

Objective

Public crises seriously affect social stability and personal health. When individuals are in a public crisis environment, they will have the impulse and intention to share information, which is a behavioral attitude shown in the face of a crisis. Public crisis information sharing intention will be affected by many factors. This study aims to examine how the process of social presence may influence information sharing intentions during a public crisis and the mediating effects of situational pressure, including risk perception of disease infection and consistency of perception of opinion climate.

Methods

This was a cross-sectional study with 505 youth SNS users. In order to collect as suitable samples as possible, a research website was commissioned to conduct a questionnaire in the early stages of the COVID-19 pandemic in China. This questionnaire was utilized to measure social presence, risk perception of disease infection, consistency of perception of opinion climate and intention to share information about COVID-19. Structural equation modeling was used to examine variable relationships in the research model.

Results

The results showed that social presence was significantly and positively associated with risk perception of disease infection (B = 0.42, p < 0.001), consistency of perception of opinion climate (B = 0.43, p < 0.001) and intention to share information about COVID-19 (B = 0.48, p < 0.001). Risk perception of disease infection (B = 0.19, p < 0.001) and consistency of perception of opinion climate (B = 0.18, p = 0.002) positively predicted youth SNS users' intention to share information about COVID-19. Risk perception of disease infection and consistency of perception of opinion climate mediated the relationship between social presence and intention to share information about COVID-19 (Z = 2.66, CI: 0.03, 0.15; Z = 2.66, CI: 0.02, 0.16).

Conclusion

The study further deepens our understanding of the mechanisms underlying social presence and information sharing intentions. These new findings suggest that some situational cues, including media environment factors (social presence) and perceived stress factors (risk perception of disease infection, consistency of perception of opinion climate) may influence information sharing intention. From the perspective of communication psychology, this study enriched the assessment of information sharing on social media and contributes to understanding of social presence and situation pressure, and it helps to provide specific references for effectively promoting netizens' intention to share information about public crises.

Exploring the impact of sentiment on multi-dimensional information dissemination using COVID-19 data in China

The outbreak of information epidemic in crisis events, with the channel effect of social media, has brought severe challenges to global public health. Combining information, users and environment, understanding how emotional information spreads on social media plays a vital role in public opinion governance and affective comfort, preventing mass incidents and stabilizing the network order. Therefore, from the perspective of the information ecology and elaboration likelihood model (ELM), this study conducted a comparative analysis based on two large-scale datasets related to COVID-19 to explore the influence mechanism of sentiment on the forwarding volume, spreading depth and network influence of information dissemination. Based on machine learning and social network methods, topics, sentiments, and network variables are extracted from large-scale text data, and the dissemination characteristics and evolution rules of online public opinions in crisis events are further analyzed. The results show that negative sentiment positively affects the volume, depth, and influence compared with positive sentiment. In addition, information characteristics such as richness, authority, and topic influence moderate the relationship between sentiment and information dissemination. Therefore, the research can build a more comprehensive connection between the emotional reaction of network users and information dissemination and analyze the internal characteristics and evolution trend of online public opinion. Then it can help sentiment management and information release strategy when emergencies occur.

Linking the Pathway from Exposure to Online Vaccine Information to Cyberchondria During the COVID-19 Pandemic: A Moderated Mediation Model

Cyberchondria describes excessive health information seeking on the Internet is associated with escalating concerns and anxiety. Drawing upon the stimulus-organism-response model, this study proposes a moderated mediation model to explore how people develop cyberchondria when they search for COVID-19 vaccine-related information on the Internet. To test the proposed model, an online survey was conducted in China. Results showed that there was a direct and positive relationship between exposure to online vaccine information and cyberchondria. This relationship was also partially mediated by perceived information overload. Moreover, e-health literacy negatively moderated the indirect relationship between exposure to online vaccine information and cyberchondria through perceived information overload. The results from this study can advance our knowledge on the development of cyberchondria during public health crises, and inform health professionals and social media operators on developing evidence-based interventions to manage this issue.

Severity assessment and the early warning mechanism of public events based on the comparison of microblogging characteristics

Purpose

The purpose of the study is to evaluate the severity of public events in real time from the perspective of social media and to construct the early warning mechanism of public events.

Design/methodology/approach

This study constructed the severity assessment system of public events from the dimensions of the netizens' role, the Internet media's role, the spread of public events and the attitudes and feelings of netizens. The method of analyzing the influence tendency of the public event severity indicators was proposed. A total of 1,107,308 microblogging entries regarding four public events were investigated. The severity of public events was divided into four levels.

Findings

It is found that serious public events have higher indicator values than medium level events on the microblogging platform. A quantitative severity classification standard for public events was established and the early warning mechanism of public events was built.

Research limitations/implications

Microblogging and other social media platforms provide rich clues for the real-time study and judgment of public events. This study only investigated the Weibo platform as the data source. Other social media platforms can also be considered in future.

Originality/value

Different from the ex-post evaluation method of judging the severity of public events based on their physical loss, this study constructed a quantitative method to dynamically determine the severity of public events according to the clues reflected by social media. The results can help the emergency management departments judge the severity of public events objectively and reduce the subjective negligence and misjudgment.

Frequent and diverse use of electronic health records in the United States: A trend analysis of national surveys

Objective

Considering the increasing integration of electronic health records (EHRs) into medical practice by healthcare organizations, it is especially pertinent to understand its actual usage by the general public in recent years. This study aims to explore factors associated with the frequency and diversity of EHR usage in the United States over time.

Methods

We analyzed three iterations (2017, 2018, and 2019) of the Health Information National Trends Survey (HINTS). HINTS is a national cross-sectional survey conducted by the National Cancer Institute to document attitudes and perceptions about health information access and use among American adults.

Results

Both frequency and diversity of EHR usage have slightly increased across the years. However, its overall usage still remained low. Three technology-related enablers (access to digital devices, access to the Internet, and perceived usefulness of EHRs) were positively related to EHR usage in all three iterations. In addition, perceived health status was a constant and negative predictor of EHR usage over years. Doctor–patient communication was positively associated with the frequency of EHR usage in two survey waves.

Conclusions

More initiatives to increase EHR usage in the United States are needed. We advocate for providing affordable Internet access and smartphone to underserved populations; in medical encounters, doctors should have more patient-centered communication, introduce the benefits of EHRs to patients, and promote EHR adoption in terms of frequency and diversity.