Perceptions About Disseminating Health Information Among Mommy Bloggers: Quantitative Study

Does Exposure to Pediatrician or Parent Blog Content Influence Infant Safe Sleep Practices?

OBJECTIVE

To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices.

METHODS

We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models.

RESULTS

The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format.

CONCLUSION

Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

User perceptions about sharing exposure notification information for communicable diseases

Background

The (GuideSafe™) Exposure Notification System (ENS) was built and deployed in (Alabama) for anonymous sending and receiving of COVID-19 exposure alerts to people who have been in close contact with someone who later reports a positive COVID-19 test. Little is known about how the demographic groups perceive recent privacy-preserving the ENS innovations, including their usability, usefulness, satisfaction, and continued interest in sharing COVID-19 exposure information. The purpose of this study was to investigate how users across the demographic groups perceive the sharing of exposure information with various types of organizations and to investigate how end-user perceptions of the ENS usability, usefulness, and satisfaction differ across the demographic groups within the context of a statewide deployment of an exposure notification system.

Methods

A survey was administered to (state residents blinded for review) (N = 1,049) to assess propensity to share COVID-19 infection data and evaluate end-user perceptions about usability, usefulness, and satisfaction with the (Alabama) ENS. The ANOVA and the Tukey's Honestly Significant Difference (HSD) post-hoc tests were conducted to assess the demographic group differences.

Results

The ENS survey participants had a high awareness of contact tracing, exposure notifications, and the (GuideSafe™) ENS and reported having downloaded the app. Survey results revealed the majority of participants rated the app as useful (n = 490, 79%), easy to use (n = 490, 79%), and reported satisfaction with its use (n = 546, 88%). Other results suggest that ethnicity and age may be important factors for trust in sharing exposure information.

Conclusion

The (GuideSafe™) system was one integrated component of comprehensive education and work re-entry strategy across (Alabama) that reached a broad user base. Users across the different demographic groups perceive the sharing of information about their communicable disease exposures differently. Furthermore, demographic factors play a role in which types of organizations individuals are willing to share their communicable disease exposure information. Public health institutions, employers, schools, healthcare providers, and technology designers may want to consider these findings as they construct technologies and perform outreach campaigns aimed at reducing infection rates with the ENS and related technologies.

Patient-Reported Outcomes in a Nationally Representative Sample of Older Internet Users: Cross-sectional Survey

BACKGROUND

The rapid diffusion of the internet has decreased consumer reliance on health care providers for health information and facilitated the patients' ability to be an agent in control of their own health. However, empirical evidence is limited regarding the effects of health-related internet use among older adults, which is complicated by the proliferation of online health and medical sources of questionable scientific accuracy.

OBJECTIVE

We explore the effects of health-related internet use, education, and eHealth literacy on medical encounters and patient-reported outcomes. Patient-reported outcomes are categorized into two dimensions: (1) self-reported health problem and (2) affective distress (feeling worried and anxious) due to information obtained. We were particularly interested in whether education and eHealth literacy moderate the association between perceived strain in medical encounters and patient-reported outcomes.

METHODS

Our study sample consisted of online panel members who have used the internet as a resource for health information, randomly drawn from one of the largest probability-based online research panels. This paper specifically reports results obtained from older panel members (age≥60 years: n=194). First, we examined descriptive statistics and bivariate associations (Pearson correlations and independent samples t tests). We used hierarchical ordinary least squares regression analyses by running separate regressions for each patient-reported outcome. In model 1, we entered the main effects. In model 2, technology and medical encounter variables were included. Model 3 added the statistical interaction terms.

RESULTS

Age (β=-.17; P=.02), gender (β=-.22; P=.01), and medical satisfaction (β=-.28; P=.01) were significant predictors of self-reported health problems. Affective distress was positively predicted by gender (β=.13; P=.05) and satisfaction with medical encounters (β=.34; P<.001) but negatively predicted by education (β=-.18; P=.03) and eHealth literacy (β=-.32; P=.01). The association between experiencing a health problem in relation to health-related internet use and perception of strained medical encounters was greater among respondents with lower levels of education (β=-.55; P=.04). There was also a significant interaction between education and eHealth literacy in predicting the level of affective distress (β=-.60; P=.05), which indicated that higher levels of education predicted lower averages of feeling anxiety and worry despite lower eHealth literacy. Older women reported higher averages of affective distress (β=.13; P=.05), while older men reported higher averages of experiencing a self-reported health problem (β=-.22; P=.01).

CONCLUSIONS

This study provides evidence for the effect of health-related internet use on patient-reported outcomes with implications for medical encounters. The results could be used to guide educational and eHealth literacy interventions for older individuals.

A Content Analysis of Social Support Messages about Environmental Breast Cancer Risk within Blogs for Mothers

Bloggers can help stimulate online conversations among their readers about a variety of health topics, including breast cancer. However, in previous studies, researchers have not specifically examined supportive messages within an online blogger community that stem from an intervention where bloggers were provided with evidence-based information about breast cancer risk that they could tailor and disseminate to their readers. In the current study, we content analyzed 282 supportive messages within online conversations from participants in blogger communities over a 2-month period immediately following an intervention where the authors provided 74 bloggers who write about motherhood issues with an infographic based on evidence-based information from the Breast Cancer and the Environment Research Program (BCERP) about environmental breast cancer risk/prevention. Bloggers who shared information about their personal breast cancer risk generated a significantly higher number of blog reader comments than bloggers who did not share information about their personal breast cancer risk. Bloggers who cited breast cancer statistics in posts were more likely to draw esteem and emotional support from their readers. Bloggers' repetition of information from blog intervention messages was more likely to elicit esteem, informational, and emotional support from readers. Disclosure of a personal breast cancer diagnosis was associated with mixed types of social support messages. The theoretical and practical implications are discussed along with key limitations of the study and future directions for research in this area.

Free Time For Wellness: a co-designed intervention utilizing social networks to encourage physical activity for cancer prevention among low resourced mothers

BACKGROUND

Physical activity is central to chronic disease prevention. Low resource mothers face structural barriers preventing them from increasing their physical activity to reduce their chronic disease risk. We co-designed an intervention, with the ultimate goal of building social cohesion through social media to increase physical activity for low resourced mothers in urban settings.

METHODS

In 2019, we interviewed 10 mothers of children (< 12 years) living in Washington Heights, Manhattan. The interviews were transcribed and coded for themes that guided the creation of a co-design workshop. Washington Heights-based mothers (n = 16) attended a co-design workshop to generate the blueprint for the Free Time for Wellness intervention.

RESULTS

Mothers in our sample had limited time, external support and resources, which hindered them from increasing their physical activity; we learned that in addition to physical health, mental health was a concern for participants. Participants had varying degrees of self-efficacy and trust in social media. Bringing mothers and researchers together in a co-design workshop, we identified types of physical activities they would enjoy participating in, the ideal time to do so, the kind of childcare they needed, and their preferences for communication with the community champion. The interviews and workshop highlighted the need for a community space that mothers and children could co-occupy. The intervention was designed to be 3 months' worth of sample programming with one activity per week, rotating between dance, yoga, food pantry visits and group playdates. Participants were invited to bring their children to a space with one room for the 'participants only' activity and a second room in which professional childcare providers supervised the children.

CONCLUSIONS

Through this two-phased co-design process, we created an intervention with mothers in an urban community with the goal of using social media to bring them together for wellness, primarily through increased physical activity. Despite the co-design of this intervention with a specific community, there are some universal applications of our findings, and of the use of co-design workshops, to other settings.

Social media use to improve communication on children and adolescent's health: the role of the Italian Paediatric Society influencers

Background

Fake news on children’s and adolescent health are spreading. Internet availability and decreasing costs of media devices are contributing to an easy access to technology by families. Public health organizations are working to contrast misinformation and promote scientific communication. In this context, a new form of communication is emerging social media influencers. Aim of this study is to evaluate the role of paediatric influencers (PI) in communicating information about children and adolescents’ health.

Materials and methods

A group of PI was enrolled from December 2019 to January 2020 by a scientific commission nominated by the Italian Paediatric Society (SIP). PI were asked to share Facebook messages from the official page of the SIP to their own network. Social media tools have been evaluated across 12 months, from July 28, 2019, to July 11, 2020. For the purposes of clarity, we schematically divided the study period as follows: the period of PIs activity (January 6, 2020, to July 11, 2020) and the period when PIs were not yet active (July 28, 2019, to January 4, 2020). Information on Facebook page (lifetime total likes, daily new likes, daily page engaged, daily total reach) and on published post (lifetime post total reach, lifetime post organic reach, lifetime engaged users) were evaluated.

Results

A significant increase in Facebook daily new likes, page engagement and total reach, as well as in lifetime post total and organic reach was evidenced. As for PI, they reported a positive experience in most cases.

Discussion

In the digital era, communication strategies are becoming more important, so that the scientific community has to be actively involved in social media communication. Our pilot study demonstrated that the recruitment of paediatric influencers has increased communication and interaction of the SIP Facebook page.

Conclusion

Our study shows the potential role of influencers: spreading health messages via PI seems to be a successful strategy to promote correct communication about children’s and adolescents’ health.

The Effectiveness of Social Media in the Dissemination of Knowledge About Pain in Dementia

Objectives

Traditional knowledge dissemination methods have been ineffective in leading to timely and widespread changes in clinical practice. Social media have the potential to reach broader audiences than more traditional methods that disseminate research findings. We evaluated the effectiveness of using social media to mobilize knowledge about pain in dementia.

Methods

We developed an online repository of evidence-based content (e.g., guidelines, assessment approaches) and a video about pain in dementia. The video was uploaded to YouTube, a video-sharing platform. We collaborated with stakeholder organizations on a 5-month social media campaign (#SeePainMoreClearly) on Twitter, a social networking site, to disseminate digital content about pain in dementia. The response to our initiatives was evaluated with Web and social media metrics, a video questionnaire, and a comparison of the extent of Twitter discussions about pain in dementia before and during the campaign period.

Results

Web metrics showed a great reach of the initiative: The #SeePainMoreClearly hashtag received more than 5,000,000 impressions and was used in 31 countries. The online repository was viewed by 1,218 individuals from 55 countries, and the video resulted in 51,000 views. Comparisons between the pre-campaign and campaign periods demonstrated a higher number of posts about pain in dementia during the campaign period.

Conclusion

The findings have implications for closing the knowledge-to-practice gap in dementia care through faster mobilization of scientific findings. Our campaign compares favorably with other health information dissemination initiatives. The methodologies used in the study could serve as a framework for the development of social media initiatives in other health disciplines.

Culturally Appropriate Breast Cancer and Environmental Risk Messages: Targeting Racially and Ethnically Diverse Mothers

The National Institute of Environmental Health Sciences (NIEHS)-funded Breast Cancer and Environment Research Program (BCERP) provides evidence-informed educational materials targeting mothers with daughters to help them engage in lifestyle changes to reduce their environmental risk of breast cancer. Building on a partnership we developed to disseminate these materials via social media, we teamed with mommy bloggers and readers to evaluate the cultural appropriateness of the information using evidence-based practices for message design. We sought to (1) identify cross-culture factors that speak to a broad group of mothers and culture-specific factors to integrate when targeting specific cultures and (2) capture cultural challenges mothers encounter when they share the information with family to understand the social context in which they receive, interpret, and act on risk-reducing messages. We conducted 50 interviews with racially and ethnically diverse bloggers/readers and thematically analyzed transcripts, comparing findings across cultures. Across cultures, mothers identified five key factors for ensuring cultural appropriateness, but with notable cultural differences: (1) incorporate diverse images, (2) provide more information specific to environmental and cultural risk, (3) heighten the message of "it's a family affair", (4) make behavioral changes feasible, and (5) use less text, more visuals. Across cultures, women experienced intergenerational communication challenges with family, which were tied to (1) lack of openness, (2) relational norms, and (3) generational resistance. Findings provide message design considerations for targeting mothers broadly or based on race/ethnicity and support the notion that the larger family system should be considered when disseminating cancer risk education.

Understanding the messages and motivation of vaccine hesitant or refusing social media influencers

BACKGROUND

While anti-vaccine messages on social media have been studied for content, reach, and effectiveness, less is known about those who create and promote the messages. Online influencers, or 'everyday people who are influential within their online social networks', are viewed as trusted voices who are often making similar life decisions as their followers. Therefore, their experiences with and perspectives on health issues can be persuasive.

METHODS

We collaborated with a formal network of online influencers to interview, using a semi-structured interview guide, vaccine hesitant influencer mothers about their views on vaccination; their process for developing health-related social media content; their motivation to promote anti-vaccine messages; and their opinions on current vaccination messaging. Prescreening ensured a diverse sample by race/ethnicity, age, education, number of children, and geographic residence. Interviews occurred by telephone, were audio recorded, and transcribed. Themes were generated independently by two coders using a deductive coding approach.

RESULTS

We interviewed 15 online influencer mothers from across the U.S. (average age 39 years old; all married; 13 Caucasian, 1 African American, 1 Hispanic). In some capacity, 5 of the 15 wrote about vaccination on their blog. Those who chose not to post anti-vaccine content did so for fear of alienating followers or having their platform be the site of combative discourse among readers. When researching their social media posts, the influencers did not trust mainstream sources of health information and relied on alternative sources and search engines.

IMPLICATIONS

This exploratory study interviewed influential mothers who have the ability to spread anti-vaccine messages on social media. While most do not contribute to the anti-vaccine sentiment, understanding the motivation and practices of those that do assists the public health community in better understanding the online vaccination communication environment, leading to more effective messages to counterbalance anti-vaccine content on social media.

Effects of Health Information Dissemination on User Follows and Likes during COVID-19 Outbreak in China: Data and Content Analysis

Background: COVID-19 has greatly attacked China, spreading in the whole world. Articles were posted on many official WeChat accounts to transmit health information about this pandemic. The public also sought related information via social media more frequently. However, little is known about what kinds of information satisfy them better. This study aimed to explore the characteristics of health information dissemination that affected users’ information behavior on WeChat. Methods: Two-wave data were collected from the top 200 WeChat official accounts on the Xigua website. The data included the change in the number of followers and the total number of likes on each account in a 7-day period, as well as the number of each type of article and headlines about coronavirus. It was used to developed regression models and conduct content analysis to figure out information characteristics in quantity and content. Results: For nonmedical institution accounts in the model, report and story types of articles had positive effects on users’ following behaviors. The number of headlines on coronavirus positively impacts liking behaviors. For medical institution accounts, report and science types had a positive effect, too. In the content analysis, several common characteristics were identified. Conclusions: Characteristics in terms of the quantity and content in health information dissemination contribute to users’ information behavior. In terms of the content in the headlines, via coding and word frequency analysis, organizational structure, multimedia applications, and instructions—the common dimension in different articles—composed the common features in information that impacted users’ liking behaviors.

Helping Mothers and Daughters Talk about Environmental Breast Cancer Risk and Risk-Reducing Lifestyle Behaviors

Background: Mothers and daughters struggle to talk about breast cancer risk. Even less attention is paid to environmental determinants of cancer. Third-party online approaches can be helpful navigating these conversations. The aim of this study was to obtain feedback from mothers exposed to a social media intervention (“mommy bloggers”) and identify their preferences for message-design approaches that could help them talk to their daughter(s) about environmental breast cancer risk. Methods: We conducted semi-structured interviews with 50 mothers. A thematic analysis was conducted using the constant comparative method. Results: Mothers identified four approaches to message design that could help facilitate mother–daughter communication about environmental breast cancer risk. These included two action-oriented approaches that centered on getting the conversation started and keeping the conversation going and two approaches based on lifespan factors to promote daughters’ engagement by using age-appropriate language and visuals and focusing on developmentally specific lifestyle behaviors. Mothers also provided recommended strategies within each approach. Conclusions: Mothers identified various approaches interventionists can utilize to overcome barriers to talking to daughters about environmental breast cancer risk. To promote mother–daughter communication, the messages should be action-oriented to facilitate interaction, but also developed with lifespan and developmental considerations in mind to engage daughters.

Partnering With Mommy Bloggers to Disseminate Breast Cancer Risk Information: Social Media Intervention

BACKGROUND

Women are concerned about reducing their breast cancer risk, particularly if they have daughters. Social media platforms, such as blogs written by mothers, are increasingly being recognized as a channel that women use to make personal and family health-related decisions. Government initiatives (eg, Interagency Breast Cancer and Environmental Research Coordinating Committee) and researchers have called for scientists and the community to partner and disseminate scientifically and community-informed environmental risk information.

OBJECTIVE

We developed and evaluated a blog intervention to disseminate breast cancer and environmental risk information to mothers. We teamed with mommy bloggers to disseminate a message that we developed and tailored for mothers and daughters based on scientific evidence from the Breast Cancer and the Environment Research Program (BCERP). We posited that the intervention would influence women's exposure to, acceptance of, and beliefs about environmental risks while promoting their intention to adopt risk-reducing behaviors.

METHODS

Using a quasi-experimental design, we recruited 75 mommy bloggers to disseminate the breast cancer risk message on their respective blogs and examined the impact of the intervention on (1) readers exposed to the intervention (n=445) and (2) readers not exposed to the intervention (comparison group; n=353).

RESULTS

Following the intervention, blog reader scores indicating exposure to the breast cancer risk and prevention information were greater than scores of blog readers who were not exposed (or did not recall seeing the message; mean 3.92, SD 0.85 and mean 3.45, SD 0.92, respectively; P<.001). Readers who recalled the intervention messages also had higher breast cancer risk and prevention information satisfaction scores compared with readers who did not see (or recall) the messages (mean 3.97, SD 0.75 and mean 3.57, SD 0.94, respectively; P<.001). Blog readers who recalled seeing the intervention messages were significantly more likely to share the breast cancer risk and prevention information they read, with their daughters specifically, than readers who did not recall seeing them (χ²₁=8.1; P=.004). Those who recalled seeing the intervention messages reported significantly higher breast cancer risk and prevention information influence scores, indicative of behavioral intentions, than participants who did not recall seeing them (mean 11.22, SD 2.93 and mean 10.14, SD 3.24, respectively; P=.003). Most women ranked Facebook as their first choice for receiving breast cancer risk information.

CONCLUSIONS

Results indicated that blog readers who were exposed to (and specifically recalled) the BCERP-adapted intervention messages from mommy bloggers had higher breast cancer risk and prevention information exposure scores and higher breast cancer risk and prevention information satisfaction and influence scores than those who did not see (or recall) them. Mommy bloggers may be important opinion leaders for some women and key to enhancing the messaging, delivery, and impact of environmental breast cancer risk information on mothers.

The "Real World"? Effects of Online Communication about Prostate Cancer on Offline Communication

INTRODUCTION

Online peer-to-peer social support programs are based on the premise that support from others who have been through a similar experience can help reduce the negative impacts of disease. Such support programs are increasingly found online, but how these conversations translate into real world interactions about health concerns is currently not well understood.

METHODS

Grounded in social network theory, this formative study explored how participants in an online prostate cancer community comprised of patients and their families translate their online conversations into offline ones. A survey was designed and fielded, and received 157 complete responses.

RESULTS

Results support prior research findings that these offline conversations are primarily information-oriented (n = 105) and extend them by the finding that members of online prostate cancer social support communities do, in fact, share information obtained online with others offline (n = 103). Family members appear to be primary receivers of this information (n = 121) while health care providers are not, which may impact treatment and care.

CONCLUSIONS

The opportunity to tie more concretely online messages with offline conversations is of critical importance and interest. Recommendations are presented for future research.