Facebook: The Use of Social Media to Engage Parents in a Preschool Obesity Prevention Curriculum

Mixed-Methods Evaluation of Father Participation in an Adolescent Obesity Prevention Program With Multiple Delivery Methods

Padres Preparados, Jóvenes Saludables was a Latino family-based obesity prevention intervention implemented from 2017 to 2020 across eight programs in-person only, in a blended format (online/in-person), and online only. The intervention aimed to enhance father parenting skills to improve adolescent diet and activity behaviors. Mothers were encouraged to attend. Factors associated with participation were explored using a mixed-methods, qualitative (focus group/individual interviews by Zoom) and quantitative (process evaluation) design. Eleven focus group and 24 individual interviews were completed after participation with 24 fathers, 27 mothers, and 40 adolescents with responses not sorted by delivery method before analysis. Binomial logistic regression models examined associations between fathers' program completion and predictor variables of delivery characteristics, father demographic characteristics, and family attendance patterns. Parents were married (96% fathers, 76% mothers), had low income, a high school education or less (68% fathers, 81% mothers), and had lived in the United States a mean of 19 years. Parents were motivated to participate to improve health, and to be involved with and improve communication with their child. Common barriers to participation were work and life priorities and programmatic factors including scheduling conflicts and technological issues. Participation was greater for fathers attending sessions in-person compared with online only (OR = 11.6). Fathers were more likely to participate if they attended sessions with family members vs. not attending with family members (OR = 7.2). To maximize participation, findings suggest involving multiple parents/caregivers and adolescents, addressing contextual and programmatic barriers, and promoting benefits of better health and relations with family members.

Social Media Web 2.0 Tools Adoption in Language and Literacy Development in Early Years: A Scoping Review

Social media tools are increasingly used in child's language and literacy development in early years. However, few researchers shed light on effectiveness and the practice that the EC professionals and teachers have adopted in ECE settings and other related contexts. This scoping review synthesized and evaluated the literature on social media integration in language and literacy development in ECE in the last decade, to provide a clearer picture on what social media tools were used, how they were used, and whether they were effective. Results showed that a wide-range of social media tools were used in diverse learning activities; however, few studies designed the learning activities with the guidance of an evidence-based teaching method or pedagogical framework.

Online reach and engagement of a child nutrition peer-education program (PICNIC): insights from social media and web analytics

BACKGROUND

Parents frequently seek parental advice online and on social media; thus, these channels should be better utilized in child health interventions. The Parents in Child Nutrition Informing Community (PICNIC) program aims to facilitate peer-to-peer sharing of evidence-based child feeding information and support parents within their social networks. The present study aimed to explore web and social media analytics to evaluate reach and user engagement with the PICNIC online components.

METHODS

Online user activity data from the PICNIC Facebook closed group and public Page were collected through Facebook Insights, and program-specific website traffic data through Google Analytics. Analytics data from Nov-2019 to April-2021 was evaluated through visualisation and summary statistics to obtain insights into program growth and current reach in Australia, compare demographics of audience reached through the online channels, and explore parents' use and engagement in PICNIC content.

RESULTS

Results showed steady program growth in the 18 months of recruitment; participant numbers grew from 102 to 261 peer educators while the Facebook Page audience increased threefold, totalling 1615 followers. Intervention posts shared on Facebook (4-5 posts/week) typically reached only a portion of PICNIC Page followers each week, but also reached a wider audience through their friends. Throughout the evaluated period, Facebook users actively engaged in PICNIC posts, although the level of engagement varied considerably from post to post. Furthermore, results from this study suggest the strategy of directing potentially interested parents from social media to the website for program sign-up was successful. Finally, the explored data gave insights into users' availability, demographics and engagement, which will be used to inform refinement of the PICNIC website and social media strategies.

CONCLUSIONS

Our findings confirm the benefits of using a peer education approach and existing social network channels to disseminate evidence-based child feeding information to parents. This study also demonstrates the usefulness of web and social media analytics to be used as part of a continuous evaluation for gaining insight to inform further development and improvement of program strategies.

TRIAL REGISTRATION

The PICNIC project was retrospectively submitted for registration with the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12622000230752 (09/02/2022).

Digital Health Promotion and Prevention in Settings: Scoping Review

BACKGROUND

Digital technologies are increasingly integrating into people's daily living environments such as schools, sport clubs, and health care facilities. These settings play a crucial role for health promotion and prevention because they affect the health of their members, as the World Health Organization has declared. Implementing digital health promotion and prevention in settings offers the opportunity to reach specific target groups, lower the costs of implementation, and improve the health of the population. Currently, there is a lack of scientific evidence that reviews the research on digital health promotion and prevention in settings.

OBJECTIVE

This scoping review aims to provide an overview of research targeting digital health promotion and primary prevention in settings. It assesses the range of scientific literature regarding outcomes such as applied technology, targeted setting, and area of health promotion or prevention, as well as identifies research gaps.

METHODS

The scoping review was conducted following the Levac, Colquhoun, and O'Brien framework. We searched scientific databases and gray literature for articles on digital setting-based health promotion and prevention published from 2010 to January 2020. We included empirical and nonempirical publications in English or German and excluded secondary or tertiary prevention and health promotion at the workplace.

RESULTS

From 8888 records, the search resulted in 200 (2.25%) included publications. We identified a huge diversity of literature regarding digital setting-based health promotion and prevention. The variety of technology types extends from computer- and web-based programs to mobile devices (eg, smartphone apps) and telemonitoring devices (sensors). We found analog, digital, and blended settings in which digital health promotion and prevention takes place. The most frequent analog settings were schools (39/200, 19.5%) and neighborhoods or communities (24/200, 12%). Social media apps were also included because in some studies they were defined as a (digital) setting. They accounted for 31.5% (63/200) of the identified settings. The most commonly focused areas of health promotion and prevention were physical activity (81/200, 40.5%), nutrition (45/200, 22.5%), and sexual health (34/200, 17%). Most of the interventions combined several health promotion or prevention methods, including environmental change; providing information, social support, training, or incentives; and monitoring. Finally, we found that the articles mostly reported on behavioral rather than structural health promotion and prevention.

CONCLUSIONS

The research field of digital health promotion and prevention in settings is heterogeneous. At the same time, we identified research gaps regarding the absence of valid definitions of relevant terms (eg, digital settings) and the lack of literature on structural health promotion and prevention in settings. Therefore, it remains unclear how digital technologies can contribute to structural (or organizational) changes in settings. More research is needed to successfully implement digital technologies to achieve health promotion and prevention in settings.

Feasibility of Using Facebook to Engage SNAP-Ed Eligible Parents and Provide Education on Eating Well on a Budget

This study examined the use of Facebook to provide education on food resource management and healthy eating on a budget to parents of preschool aged children participating in Head Start. A convenience sample of 25 parents participated in a Facebook group based on Sesame Street's Food for Thought: Eating Well on a Budget curriculum over a 3-week period. Parent engagement was assessed by examining views, likes, and comments on posts. Qualitative data were used to assess knowledge, attitudes, and barriers experienced related to healthy eating on a budget. The results suggest that parents were engaged throughout the intervention, as evidenced by views, likes, and comments on Facebook posts, as well as by study retention (90%). Interactions with the intervention materials varied by post content, with discussion questions having the highest level of interaction. Facebook was found to be a feasible platform for delivering the intervention, and the Facebook-adapted version of the Sesame Street curriculum was shown to engage Head Start parents living in rural areas. Further research should explore the use of social media platforms for delivering nutrition education interventions to rural populations that are otherwise difficult to reach.

#childhoodobesity - A brief literature review of the role of social media in body image shaping and eating patterns among children and adolescents

Children's food preferences are closely related to their parents' food preferences and knowledge of food is linked to what their parents share with them. Parents, however, are not the only people who model such behavior. Paradoxically, the ubiquitous technological development can also pose a huge threat. In developed countries, 94% of teenagers use social media platforms such as: Instagram, Snapchat, Facebook, or TikTok, and this also applies to children. It can therefore be argued that parents' nutritional preferences and behavior are related to the same behaviors of children and there is an extensive literature on this subject. It is therefore important to check how other factors - new technology (and social media in particular) - can influence changes in this area. A literature search was conducted in the following databases: Google Scholar, PubMed, EBSCO in December 2021. After applying all the filters and verification of relevance in terms of the research on the topic of interest to us, 4 articles related to research on body image and social media and 4 articles related to research on food choices and social media among children and adolescents were obtained. The conducted analysis showed that various studies so far indicate that social media can have a very strong influence on the development of eating patterns and body image in children and adolescents, which in turn may be one of the risk factors for developing obesity when promoted behaviors are not associated with a healthy lifestyle. It is also worth pointing out that social media can be used as a resource in the prevention and treatment of obesity. A closer look at this topic seems to be particularly important due to the fact that, among adults, social media is not only a very important source of information about lifestyle, but also a source of social support when people attempting to lose weight. Therefore, by increasing preventive activity in social media and using modern solutions related to social media (including the use of hashtag signs), we can have a greater impact on the health awareness of children and adolescents around the world.

Weight Stigma and Social Media: Evidence and Public Health Solutions

Weight stigma is a pressing issue that affects individuals across the weight distribution. The role of social media in both alleviating and exacerbating weight bias has received growing attention. On one hand, biased algorithms on social media platforms may filter out posts from individuals in stigmatized groups and concentrate exposure to content that perpetuates problematic norms about weight. Individuals may also be more likely to engage in attacks due to increased anonymity and lack of substantive consequences online. The critical influence of social media in shaping beliefs may also lead to the internalization of weight stigma. However, social media could also be used as a positive agent of change. Movements such as Body Positivity, the Fatosphere, and Health at Every Size have helped counter negative stereotypes and provide more inclusive spaces. To support these efforts, governments should continue to explore legislative solutions to enact anti-weight discrimination policies, and platforms should invest in diverse content moderation teams with dedicated weight bias training while interrogating bias in existing algorithms. Public health practitioners and clinicians should leverage social media as a tool in weight management interventions and increase awareness of stigmatizing online content among their patients. Finally, researchers must explore how experiences of stigma differ across in-person and virtual settings and critically evaluate existing research methodologies and terminology. Addressing weight stigma on social media will take a concerted effort across an expansive set of stakeholders, but the benefits to population health are consequential and well-worth our collective attention.

A Year of Child Injury Prevention on Instagram

Injury is the leading cause of death for children but little is known about what types of injury prevention messages are communicated on Instagram. Conducted in the United States, the aim of this study was to better understand child injury prevention messages on Instagram to develop recommendations for the future. Informed by Social Cognitive Theory, a quantitative content analysis was conducted on all Instagram posts from selected organizations from May 2018 through April 2019. Of the 818 injury prevention posts, almost all included an image (575, 70%) or video (211, 26%). Of the 575 images, 245 (42.46%) had in image that did not match the topic of the post. Regarding injury prevention recommendations, 579 posts (71%) provided a clear action that parents should take. For these posts, 115 (20%) had an image that communicated the desired safety recommendation, but many more (285, 50%) did not; in 23 cases it was not clear if there was a match or not. There are missed opportunities for child health and injury organizations to reach parents and caregivers through Instagram. Posts made during the study period often lacked specificity about action-oriented measures and failed to utilize images that demonstrated the recommended practices. Organizations posting on Instagram and other social media platforms should provide clear action tips and utilize images that depict child injury prevention recommendations.

Assessment of Cooking Matters Facebook Platform to Promote Healthy Eating Behaviors among Low-Income Caregivers of Young Children in the United States: A Pilot Study

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes pre- and post-following CM Facebook. A binary indicator was developed to measure whether the outcomes were improved (1 = Improved; 0 = Not improved). Multi-variable logistic regressions were applied to examine the relationship between whether the outcome was improved with reference to the baseline socio-demographics. No significant differences were detected between pre and post outcomes overall (p > 0.05), except improvement in feeding healthy meals within the budget available (p < 0.05). However, improvement in select outcomes was more significant in men and single-parent households. The CM Facebook page could be an important platform to influence low-income caregivers of young children.

Feasibility and Efficacy of the "FUNPALs Playgroup" Intervention to Improve Toddler Dietary and Activity Behaviors: A Pilot Randomized Controlled Trial

This study evaluated the feasibility and effects of the Families Understanding Nutrition and Physically Active Lifestyles (FUNPALs) Playgroup on toddler (12–36-month-old) diet and activity behaviors. Parent–toddler dyads were recruited from disadvantaged communities and randomly assigned to receive 10-weekly sessions of the FUNPALs Playgroup (n = 24) or dose-matched health education control group (n = 26). FUNPALs Playgroups involved physical and snack activities, delivery of health information, and positive parenting coaching. The control group involved group health education for parents only. Process outcomes (e.g., retention rate, fidelity) and focus groups determined feasibility and perceived effects. To evaluate preliminary effects, validated measures of toddler diet (food frequency questionnaire and a carotenoid biomarker), physical activity (PA; accelerometers), general and feeding parenting (self-report surveys), and home environment (phone interview) were collected pre and post. The sample comprised parents (84% female) who self-identified as Hispanic/Latino (38%) and/or African American (32%). Retention was high (78%). Parents from both groups enjoyed the program and perceived improvements in their children’s health behaviors. Objective measures demonstrated improvement with large effects (η² = 0.29) in toddler diet (p < 0.001) but not PA (p = 0.099). In conclusion, the FUNPALs Playgroup is feasible and may improve toddler eating behaviors.

The Body Confident Mums challenge: a feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook

Background

Motherhood is a time of intense physical, psychological, and identity transformation, and body dissatisfaction may emerge through the process of pregnancy, birth, and adaptation to parenting. We present a feasibility trial of the Body Confident Mums Challenge, a program developed by adapting existing, effective interventions that focus on self-compassion and appreciation of body functionality to be specific to mothers.

Methods

The program was delivered using the social learning function in a closed Facebook group. Qualitative evaluation of evidence of change was conducted by gathering individual written reflections posted during the challenge (n = 120). Feasibility and acceptability was determined using a feedback survey (n = 22).

Results

Participant’s reflective posts indicated that they were embracing self-compassion, and de-prioritising body image concerns during the challenge. Feedback indicated that the program was mostly feasible and acceptable for mothers, with recommendations from some participants relating to slowing the pace of content delivery and reducing the time commitment of the Challenge.

Conclusions

The social media environment may therefore be a useful setting in which to implement brief intervention programs to improve body image and wellbeing.

Healthy Food on the Twitter Social Network: Vegan, Homemade, and Organic Food

Online social networks have become an everyday aspect of many people’s lives. Users spend more and more time on these platforms and, through their interactions on social media platforms, they create active and passive digital footprints. These data have a strong potential in many research areas; indeed, understanding people’s communication on social media is essential for understanding their attitudes, experiences, behaviors and values. Researchers have found that the use of social networking sites impacts eating behavior; thus, analyzing social network data is important for understanding the meaning behind expressions used in the context of healthy food. This study performed a communication analysis of data from the social network Twitter, which included 666,178 messages posted by 168,134 individual users. These data comprised all tweets that used the #healthyfood hashtag between 2019 and 2020 on Twitter. The results revealed that users most commonly associate healthy food with a healthy lifestyle, diet, and fitness. Foods associated with this hashtag were vegan, homemade, and organic. Given that people change their behavior according to other people’s behavior on social networks, these data could be used to identify current and future associations with current and future perceptions of healthy food characteristics.

Food parenting topics in social media posts: Development of a coding system, examination of frequency of food parenting concepts, and comparison across Reddit and Facebook

This study presents development of a coding system to examine food parenting topics presented in posts on social media, and compared topics between two social media platforms (Facebook, Reddit). Publicly available social media posts were gathered from Facebook (2 groups) and Reddit (3 subreddits) and a coding system was developed based on the concept map of food parenting proposed by Vaughn et al. (2016). Based on the developed coding system, we coded posts into overarching food parenting practice constructs (coercive control: attempts to dominate, pressure or impose parents' will on child, structure: organization of child's environment to facilitate competence, autonomy support: supporting child's ability to self-regulate through allowing food choices, conversations about food, and a positive emotional climate) and recipes. We also coded posts dichotomously as including a question or advice-seeking. Differences in frequencies of food parenting constructs presented in posts on Facebook and Reddit were considered using chi-square tests of independence. Of the 2459 posts coded, 900 were related to food parenting (37%). In the subsample of 900, posts related to structure (43%) and recipes (40%) were the most frequent. Close to half of the posts (44%) included questions about food parenting. Frequency of food parenting topics in posts was related to social media platform, with coercive control and structure more frequently discussed on Reddit and recipes more commonly posted on Facebook. Results suggest that food parenting topics discuss on social media differ by platform, which can aid researchers and practitioners in targeting social media-based outreach to the topics of most interest for users. Findings give insight into the everyday food parenting topics and questions that parents and caregivers may be exposed to on social media. TAXONOMY: Development of Feeding; Parenting; Online Information Services.

Using Social Media to Understand Online Social Factors Concerning Obesity: A Systematic Review (Preprint)

Background

Evidence in the literature surrounding obesity suggests that social factors play a substantial role in the spread of obesity. Although social ties with a friend who is obese increase the probability of becoming obese, the role of social media in this dynamic remains underexplored in obesity research. Given the rapid proliferation of social media in recent years, individuals socialize through social media and share their health-related daily routines, including dieting and exercising. Thus, it is timely and imperative to review previous studies focused on social factors in social media and obesity.

Objective

This study aims to examine web-based social factors in relation to obesity research.

Methods

We conducted a systematic review. We searched PubMed, Association for Computing Machinery, and ScienceDirect for articles published by July 5, 2019. Web-based social factors that are related to obesity behaviors were studied and analyzed.

Results

In total, 1608 studies were identified from the selected databases. Of these 1608 studies, 50 (3.11%) studies met the eligibility criteria. In total, 10 types of web-based social factors were identified, and a socioecological model was adopted to explain their potential impact on an individual from varying levels of web-based social structure to social media users’ connection to the real world.

Conclusions

We found 4 levels of interaction in social media. Gender was the only factor found at the individual level, and it affects user’s web-based obesity-related behaviors. Social support was the predominant factor identified, which benefits users in their weight loss journey at the interpersonal level. Some factors, such as stigma were also found to be associated with a healthy web-based social environment. Understanding the effectiveness of these factors is essential to help users create and maintain a healthy lifestyle.

Can Parental Engagement in Social Media Enhance Outcomes of an Online Healthy Lifestyle Program for Preschool-Aged Children?

This study explored parental engagement, child BMI and secondary outcomes from the social media component of an online healthy lifestyle program for parents of preschool-aged children. Intervention group participants received access to an online program and Facebook group. Data were collected at baseline and 3- and 6-months follow-up. Facebook usage data on comments and posts were used to determine total active engagement. There was a high level of Facebook group membership and most parents actively engaged at least once. Although there were varying levels of engagement between modules and cohorts, it was modest overall. User acceptability of the Facebook group was lower than expected. Children of parents in the intervention who engaged more in the Facebook group (by posting and commenting) demonstrated greater sleep duration over time (estimate 1.79, 95% CI 0.42 to 3.17, p = .01) Children of parents who engaged more in the Facebook group also participated in less moderate- to vigorous-intensity physical activity (estimate -0.14, 95% CI -0.26 to -0.01, p = .03). This study is one of the first parent-focussed healthy lifestyle interventions to include a social media component. Further research is recommended with larger sample sizes and longer duration to further explore the potential of social media in childhood obesity interventions.

Evaluation of "Together, We Inspire Smart Eating" (WISE) nutrition intervention for young children: Assessment of fruit and vegetable consumption with parent reports and measurements of skin carotenoids as biomarkers

Resonance Raman spectroscopy (RRS) and parent report were used to assess dietary intake of fruit and vegetable (FV) consumption among young children experiencing a nutrition intervention. The nutrition intervention was "Together, We Inspire Smart Eating" (WISE). The study followed a convenience sample of low-income children in preschool (N=175) and early elementary (N=199) classrooms over an academic school year. Data were collected in a Southern, rural U.S state. Results of pre- and post-assessments indicated statistically improved consumption of FV at follow-up compared to baseline. Results were consistent using both assessment methods supporting the use of either assessment method.

Together, We Inspire Smart Eating (WISE): An Examination of Implementation of a WISE Curriculum for Obesity Prevention in Children 3 to 7 Years

This study examined the implementation of a school-based, obesity prevention curriculum, Together, We Inspire Smart Eating (WISE), targeting 3- to 7-year-old low-income children. Survey data from a convenience sample were collected from educators and parents (N = 73, N = 188, respectively) at the beginning and end of a school year in which WISE was implemented. Educators also reported on lessons weekly. Measures to evaluate the success of the implementation were conceptually distinct implementation outcomes (Educators: Perceived Barriers, Appropriateness, Acceptability, Feasibility, Fidelity; Parents: Adoption, Appropriateness). WISE was successfully implemented in 33 target classrooms representing 7 preschool centers and 2 elementary schools. Based on educator report, perceived barriers were reduced. Educators rated Appropriateness, Acceptability, and Feasibility high. Evidence of Fidelity was mixed. Parents reported indicators of Adoption and Appropriateness high. The study provided support for WISE in preschools and elementary schools serving young children from low-resource homes.

mHealth Improved Fruit and Vegetable Accessibility and Intake in Young Children

OBJECTIVE

To explore the potential of mHealth using smartphones to improve fruit and vegetable intake in children.

DESIGN

A 10-week randomized control and intervention pilot study.

SETTING

Story time sessions at local libraries.

PARTICIPANTS

A convenience sample of 30 parents and children (aged 3-8 years).

INTERVENTION

Delivery of nutrition intervention through the mobile Jump2Health website, Facebook posts, and text messages.

MAIN OUTCOME MEASURES

Electronic food photos of children's meals and snacks, 10-question survey related to fruit and vegetable consumption, reflectance spectroscopy via Veggie Meter to measure skin carotenoid levels, body mass index percentiles, and a mobile learning survey.

ANALYSIS

Descriptive statistics and Wilcoxon matched-pairs signed-rank test.

RESULTS

Veggie Meter values for children and parents showed significant week × treatment interactions in the intervention group compared with the control group for both children (P < .001 and parents (P < .001).

CONCLUSIONS AND IMPLICATIONS

This pilot study offers a potentially effective program including a mobile Web site, social media, and test message components to increase fruit and vegetable intake of young children.

Evaluation of Together We Inspire Smart Eating: pre-school fruit and vegetable consumption

This study examined nutrition intervention curriculum, Together We Inspire Smart Eating (WISE). WISE is a research-based, nutrition promotion curriculum specifically designed for pre-school children from families with limited resources. The design was non-randomized treatment/control with standardized pre-/post-test assessments. Children (n = 268) in six Head Start centers received weekly food experiences from educators trained in WISE. Children (n = 258) in nine Head Start centers received weekly food experiences structured at the discretion of the educators untrained in WISE. Parents in both conditions (n = 268 WISE classroom, n = 258 comparison) were interviewed by educators twice over the school year using a data collection tool, The Family Map Inventory. Analyses using full information maximum likelihood controlling for pre-intervention consumption and key demographic characteristics was used to predict consumption at post-intervention assessment. Results indicated children in WISE centers consumed healthier food at home than children in non-WISE classrooms. The study suggested that WISE curriculum is an effective method to improve children's diets in at-risk environments.

Generating Engagement on the Make Healthy Normal Campaign Facebook Page: Analysis of Facebook Analytics

Background

Facebook is increasingly being used as part of mass media campaigns in public health, including the Make Healthy Normal (MHN) campaign in New South Wales, Australia. Therefore, it is important to understand what role Facebook can play in mass media campaigns and how best to use it to augment or amplify campaign effects. However, few studies have explored this.

Objective

This study aimed to investigate usage of and engagement with the MHN Facebook page and to identify influential factors in driving engagement with the page.

Methods

We examined both post-level and page-level analytic data from Facebook from the campaign’s launch in June 2015 to September 2017. For post-level data, we conducted a series of negative binomial regressions with four different outcome measures (likes, shares, comments, post consumers), including some characteristics of Facebook posts as predictors. We also conducted time series analyses to examine associations between page-level outcomes (new page likes or “fans” and number of engaged users) and different measures of exposure to the page (number of unique users reached and total count of impressions) and to television advertising.

Results

Of the 392 posts reviewed, 20.7% (n=81) received a paid boost and 58.9% (n=231) were photo posts. We found that posts that received a paid boost reached significantly more users and subsequently received significantly more engagement than organic (unpaid) posts (P<.001). After adjusting for reach, we found the effect of being paid was incremental for all outcome measures for photos and links, but not videos. There were also associations between day of the week and time of post and engagement, with Mondays generally receiving less engagement and posts on a Friday and those made between 8 AM and 5 PM receiving more. At the page level, our time series analyses found that organic impressions predicted a higher number of new fans and engaged users, compared to paid impressions, especially for women. We also found no association between television advertising and engagement with the Facebook page.

Conclusions

Our study shows that paying for posts is important for increasing their reach, but that page administrators should look to maximize organic reach because it is associated with significantly higher engagement. Once reach is accounted for, video posts do not benefit from being paid, unlike the other post types. This suggests that page administrators should carefully consider how they use videos as part of a Facebook campaign. Additionally, the lack of association between television advertising and engagement suggests that future campaigns consider how best to link different channels to amplify effects. These results highlight the need for ongoing evaluation of Facebook pages if administrators are to maximize engagement.

The Provision of Assistance Does Not Substantially Impact the Accuracy of 24-Hour Dietary Recalls Completed Using the Automated Self-Administered 24-H Dietary Assessment Tool among Women with Low Incomes

Background

Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income.

Objective

This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance.

Methods

Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes.

Results

Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22).

Conclusions

ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy.

Prospects for early childhood feeding interventions: An exploration of parent's concerns and acceptability towards social media intervention opportunities

AIM

The present study aims to (i) consult with parents regarding child feeding concerns, as relevant to child feeding interventions, (ii) determine parents' willingness to participate in online and social media-based interventions and (iii) determine differences in intervention acceptability based on geographic diversity and demographic characteristics.

METHODS

Three hundred thirty Australian parents of children (2.0-5.0 years) with child feeding concerns participated in an online, cross-sectional survey. Kruskal-Wallis with Dunn's multiple-comparison test, using Bonferroni adjustment, was used to compare differences between variables and participants characteristics (region of residence, parent age, parent education and income).

RESULTS

About 53.9% of respondents were concerned about child fussy eating, with lack of time and child tantrums common barriers to addressing concerns. Respondents indicated that a combination of online platforms (websites, email, Facebook) was their preferred method of intervention participation, although, a combination of online and face-to-face methods also had modest preference, particularly among lower educated parents. Participants indicated that they would participate in an online intervention (participating once a week) for more than 12 weeks (42.7%), compared with only 4 weeks (participating once a week) for traditionally delivered interventions. About 32.4% of respondents said they would be concerned about their privacy in an online intervention.

CONCLUSIONS

Fussy eating is likely to be an appealing focus for future child feeding interventions, with strategies to address common barriers an important curriculum area. Online interventions are likely to offer an acceptable and plausible alternative to traditional interventions that are able to reach geographically diverse populations, although face-to-face intervention components still hold appeal.

Effect of Social Media on Child Obesity: Application of Structural Equation Modeling with the Taguchi Method

Through public health studies, specifically on child obesity modeling, research scholars have been attempting to identify the factors affecting obesity using suitable statistical techniques. In recent years, regression, structural equation modeling (SEM) and partial least squares (PLS) regression have been the most widely employed statistical modeling techniques in public health studies. The main objective of this study to apply the Taguchi method to introduce a new pattern rather than a model for analyzing the body mass index (BMI) of children as a representative of childhood obesity levels mainly related to social media use. The data analysis includes two main parts. The first part entails selecting significant indicators for the proposed framework by applying SEM for primary and high school students separately. The second part introduces the Taguchi method as a realistic and reliable approach to exploring which combination of significant variables leads to high obesity levels in children. AMOS software (IBM, Armonk, NY, USA) was applied in the first part of data analysis and MINITAB software (Minitab Inc., State College, PA, USA) was utilized for the Taguchi experimental analysis (second data analysis part). This study will help research scholars view the data and a pattern rather than a model, as a combination of different factor levels for target factor optimization.