Social media for public health: Reaping the benefits, mitigating the harms

Linking internet health information seeking to psychological distress among Chinese adults with a family cancer history: The attenuating role of patient-clinician communication of internet searches

OBJECTIVE

The psychological distress faced by individuals with a family cancer history (FCH) has emerged as a significant concern. This study examined the relationship between Internet health information seeking (IHIS) and psychological distress, focusing on the mediating roles of cancer information overload and cancer worry and the moderating role of patient-clinician communication of Internet searches.

METHODS

In 2023, a nationally representative online survey was conducted. This research encompassed a cohort of 580 Chinese adults with FCH and no personal cancer history. Moderated mediation analysis was employed.

RESULTS

IHIS was not directly associated with psychological distress. However, it increased cancer information overload and cancer worry, which in turn exacerbated psychological distress. In addition, among people who discussed their online searches with healthcare providers, the positive association between IHIS and cancer information overload became nonsignificant.

CONCLUSION

The current study elucidates a mediation mechanism of cancer information overload and cancer worry in understanding the association between IHIS and psychological distress among individuals with FCH. Patient-clinician communication serves a prophylactic role by attenuating these adverse effects.

PRACTICAL IMPLICATIONS

Encouraging patient-clinician dialogues about Internet health information may be promising in curbing cancer information overload. Healthcare providers should proactively engage in such discussions to support patients' psychological health.

Short communication: Mpox memes, the gift that conceals a blade

Memes have become a popular communication tool, especially during public health crises, offering both opportunities and challenges for messaging. This short communication examines the dual role of mpox-related memes circulating since the disease's declaration as a public health emergency in August 2024. Through a qualitative content analysis of 200 mpox memes shared across major social media platforms, we identified two primary themes: (1) Awareness and Education and (2) Misinformation and Stigma. Approximately 60% of the memes promoted awareness, using humor to increase engagement with health messages and fostering constructive dialogue on preventive measures. However, 40% conveyed misinformation or perpetuated stigma, particularly against LGBTQ+ communities, which may have hindered public trust in health authorities and created barriers to health-seeking behaviors. The findings suggest that while memes can positively impact public health communication, their potential to spread misinformation requires strategic monitoring and response. Public health organizations may benefit from partnering with social media influencers to create accurate, relatable meme content that engages audiences without perpetuating harmful stereotypes.

Navigating the Maze of Social Media Disinformation on Psychiatric Illness and Charting Paths to Reliable Information for Mental Health Professionals : An Observational Analysis

BACKGROUND

Disinformation on social media can seriously affect mental health by spreading false information, increasing anxiety, stress, and confusion in vulnerable individuals as well as perpetuating stigma. This flood of misleading content can undermine trust in reliable sources and heighten feelings of isolation and helplessness among users.

OBJECTIVE

This study aimed to explore the phenomenon of disinformation about mental health on social media and provide recommendations to mental health professionals that would use social media platforms to create educational videos about mental health topics.

METHODS

A comprehensive analysis conducted on 1000 TikTok videos from over 16 countries, available in English, French, and Spanish, covering 26 mental health topics. The data collection was conducted using a framework on disinformation and social media. A multilayered perceptron algorithm was used to identify factors predicting disinformation. Recommendations to health professionals about the creation of informative mental health videos were designed as per the data collected.

RESULTS

Disinformation was predominantly found in videos about neurodevelopment, mental health, personality disorders, suicide, psychotic disorders, and treatment. A machine learning model identified weak predictors of disinformation, such as an initial perceived intent to disinform and content aimed at the general public rather than a specific audience. Other factors, including content presented by licensed professionals like a counseling resident, an ear-nose-throat surgeon, or a therapist, and country-specific variables from Ireland, Colombia, and the Philippines, as well as topics like adjustment disorder, addiction, eating disorders, and impulse control disorders, showed a weak negative association with disinformation. In terms of engagement, only the number of favorites was significantly associated with a reduction in disinformation. Five recommendations were made to enhance the quality of educational videos about mental health on social media platforms.

CONCLUSIONS

This study is the first to provide specific, data-driven recommendations to mental health providers globally, addressing the current state of disinformation on social media. Further research is needed to assess the implementation of these recommendations by health professionals, their impact on patient health, and the quality of mental health information on social networks.

CLINICALTRIAL

Evaluating Online Cannabis Health Information for Thai Breast Cancer Survivors Using the Quality Evaluation Scoring Tool (QUEST): Mixed Method Study

Background

Following medical cannabis legalization in Thailand in 2019, more people are seeking medical cannabis-related information, including women living with breast cancer. The extent to which they access cannabis-related information from internet sources and social media platforms and the quality of such content are relatively unknown and need further evaluation.

Objective

This study aims to analyze the factors determining cannabis-related content quality for breast cancer care from internet sources and on social media platforms and examine the characteristics of such content accessed and consumed by Thai breast cancer survivors.

Methods

A mixed methods study was conducted between January 2021 and May 2022, involving a breast cancer survivor support group. The group identified medical cannabis-related content from frequently accessed internet sources and social media platforms. The contents were categorized based on content creators, platforms, content category, and upload dates. Four researchers used the Quality Evaluation Scoring Tool (QUEST) to assess content quality, with scores ranging from 0 to 28. Contents were expert-rated as either high or poor. The QUEST interobserver reliability was analyzed. Receiver-operating characteristic curve analysis with the Youden index was used to determine the QUEST score cut-off point. Statistical significance was set at P<.05. Fairclough Critical Discourse Analysis was undertaken to examine the underlying discourses around poor-quality content.

Results

Sixty-two Thai-language cannabis-related items were evaluated. The content sources were categorized as follows: news channels (21/62, 34%), government sources (16/62, 26%), health care providers (12/62, 19%), and alternative medicine providers (12/62, 19%). Most of the contents (30/62, 48%) were uploaded to YouTube, whereas 31% (19/62) appeared on websites and Facebook. Forty of 62 content items (64%) were news-related and generic cannabis advertisements while 8 of 62 (13%) content items had no identifiable date. The interobserver QUEST score correlation was 0.86 (P<.001). The mean QUEST score was 12.1 (SD 7.6). Contents were considered "high" when the expert rating was >3. With a QUEST score of 15 as the threshold, the sensitivity and specificity for differentiating between high and poor content quality were 81% and 98%, respectively. Content creation was the only significant factor between high- and poor-quality content. Poor-quality contents were primarily created by alternative medicine providers and news channels. Two discourses were identified: advocacy for cannabis use normalization and cannabis romanticization as a panacea. These discourses overly normalize and romanticize the use of cannabis, focusing on indications and instructions for cannabis use, and medical cannabis promotion, while neglecting discussions on cannabis contraindications and potential side effects.

Conclusions

The varying quality of medical cannabis-related information on internet sources and social media platforms accessed and shared by Thai breast cancer survivors is an issue of concern. Given that content creators are the sole predictive factors of high content quality, future studies should examine a wider range of cannabis-related sources accessible to both the public and patients to gain a more comprehensive understanding of the issue.

Understanding public response: Government communication during the COVID-19 crisis through the eyes of the Swiss public

Objective

To analyze the Swiss public perception of COVID-19 communication by the government and its impact on behavior and trust.

Methods

A cross-sectional representative online survey was conducted in January 2022 in a sample of 2587 Swiss residents.

Results

Overall the survey showed moderate satisfaction with communication, with relevance rated highly. Perceptions of communication varied across demographics. Also, differences were noted in trust in institutions, risk perception, and attitudes towards public health measures based on perceived communication quality.

Conclusion

This study highlights the dynamic nature of public health communication and underscores the significance of continuous adaptation and evaluation of strategies to effectively reach and influence diverse audiences. As misinformation persists, the study underscores the need for informative, empathetic, and honest communication, as well as tailored approaches to build public trust-an essential asset for managing health crises successfully.

Innovation

This study provides innovative concrete insights into how governmental communication could be designed more strategically to effectively communicate with the public in contexts characterized by disinformation, emphasizing the role of quality, honest, and empathetic communication in public health messaging.

Social Media and Digital Inequity: Reducing Health Inequities by Closing the Digital Divide

As its usage has grown, social media has positively and negatively impacted public health. Although social media presents known harms to mental health and spreads misinformation, it also offers rapid dissemination of public health information, expanded access to health resources, and a robust source of health information. However, these benefits are not equitably shared due in part to the "digital divide" of unequal access and use of information and communication technologies. Measurable inequalities in digital access exist among regions, with an eight-fold difference between Central Africa (9.8% social media penetration) and Northern Europe (80.2% social media penetration). Digital inequalities also differ by gender, age, and socioeconomic classes within countries. Increased digital access has been positively associated with improved health information and outcomes related to chronic diseases, infectious disease outbreaks, and reproductive health. Given the expanding role of social media in public health and the emerging evidence on the health benefits of digital access, we argue for reducing digital inequities by (1) creating an enabling government policy and regulatory environment that views digital health access as a social determinant of health; (2) targeting public and private investments to expand digital access for underserved regions and populations; (3) making digital access and use affordable to low-resource populations; and (4) improving digital competency among these groups through digital literacy programs.

Sentiment analysis of post-COVID-19 health information needs of autism spectrum disorder community: insights from social media discussions

OBJECTIVE

This study explores the health information needs of individuals with autism spectrum disorder (ASD) and their caregivers in the post-COVID-19 era by analyzing discussions from Reddit, a popular social media platform.

METHODS

Utilizing a mixed-method approach that integrates qualitative content analysis with quantitative sentiment analysis, we analyzed user-generated content from the "r/autism" subreddit to identify recurring themes and sentiments.

RESULTS

The qualitative analysis uncovered key themes, including symptoms, diagnostic challenges, caregiver experiences, treatment options, and stigma, reflecting the diverse concerns within the ASD community. The quantitative sentiment analysis revealed a predominance of positive sentiment across discussions, although significant instances of neutral and negative sentiments were also present, indicating varied experiences and perspectives among community members. Among the machine learning models used for sentiment classification, the Bi-directional Long Short-Term Memory (Bi-LSTM) model achieved the highest performance, demonstrating a validation accuracy of 95.74%.

CONCLUSIONS

The findings highlight the need for improved digital platforms and community resources to address the specific health information needs of the ASD community, particularly in enhancing access to reliable information and fostering supportive environments. These insights can guide future interventions and policies aimed at improving the well-being of autistic persons and their caregivers.

Personal values clusters and their associations to social media behaviors and psychological well-being

The current study contributes to the literature by assessing the associations between personal values, explored with Schwartz`s Portrait Values Questionnaire, social media behaviors, assessed with Bergen Scale of Social Media Addiction and Social Media Motivations to Use Scale and psychological well-being assessed with Patient Health Questionnaire-4, in a sample of first-year medical students. It was examined medical students' personal values profiles and the perceived influence of social media on self-aspects. All participants (N = 151) were Romanian and English module students, young (average age = 19.2, SD = 1.5), 68,9% females and 31,1% males. Pearson coefficient correlation analyses were performed to verify the associations between the main four clusters of personal values (Self Transcendence, Self Enhancement, Openness to change and Conservationism) with social media behaviors and psychological wellbeing. The most frequent cluster of values was Self-Transcendence (M = 5.21) while the least was Self-Enhancement (M = 4.05). There was no significant correlation between social media addiction, psychological wellbeing and a specific cluster of values while the perception of self-aspects influenced by social media included involvement in community problems, creativity for Openness to change group (R = .24;.22, p < .05), tolerance towards sexual minorities and self-evaluation in Self Transcendence group (R = .24;.21;.42, p < .05) while Conservationism and Self Enhancement groups didn`t report any change. The findings highlight the need for awareness and education of medical students and general population in the field of Digital Ethics including social media complex impact on personal values as AI-algorithms may imply a potential destabilization and perpetual shaping of one`s behavior with still unpredictable individual and societal effects.

Dynamics of combatting market-driven epidemics: Insights from U.S. reduction of cigarette, sugar, and prescription opioid consumption

Misuse and overconsumption of certain consumer products have become major global risk factors for premature deaths, with their total costs in trillions of dollars. Progress in reducing such deaths has been slow and difficult. To address this challenge, this review introduces the definition of market-driven epidemics (MDEs), which arise when companies aggressively market products with proven harms, deny these harms, and resist mitigation efforts. MDEs are a specific within the broader landscape of commercial determinants of health. We selected three illustrative MDE products reflecting different consumer experiences: cigarettes (nicotine delivery product), sugar (food product), and prescription opioids (medical product). Each met the MDE case definition with proven adverse health impacts, well-documented histories, longitudinal product consumption and health impact data, and sustained reduction in product consumption. Based on these epidemics, we describe five MDE phases: market expansion, evidence of harm, corporate resistance, mitigation, and market adaptation. From the peak of consumption to the most recent data, U.S. cigarette sales fell by 82%, sugar consumption by 15%, and prescription opioid prescriptions by 62%. For each, the consumption tipping point occurred when compelling evidence of harm, professional alarm, and an authoritative public health voice and/or public mobilization overcame corporate marketing and resistance efforts. The gap between suspicion of harm and the consumption tipping point ranged from one to five decades-much of which was attributable to the time required to generate sufficient evidence of harm. Market adaptation to the reduced consumption of target products had both negative and positive impacts. To our knowledge, this is the first comparative analysis of three successful efforts to change the product consumption patterns and the associated adverse health impacts of these products. The MDE epidemiological approach of shortening the latent time to effective mitigation provides a new method to reduce the impacts of harmful products.

From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions

In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.

COVID-19 and mental health services in Sub-Saharan Africa: A critical literature review

BACKGROUND

The COVID-19 pandemic has wrought a profound impact on mental health in Sub- Saharan Africa, exacerbating existing disparities and rendering individuals undergoing treatment particularly susceptible. This comprehensive critical review delves into the scope, nature, and extent of COVID-19 impact on mental health services in Sub- Saharan Africa, while concurrently elucidating pivotal lessons and exemplary practices learnt from periods of lockdown.

METHODS

The methodology was guided by Jesson & Laccy's guide on how to conduct critical literature reviews. Articles were comprehensively sought through two academic databases (PubMed and Google Scholar), complemented by targeted searches on the WHO website and official public health websites of relevant Sub-Saharan African countries.

RESULTS

The investigation reveals a surge in mental health challenges, notably marked by a significant escalation in anxiety, depression, and post-traumatic stress disorder. Disruptions to care services, financial hardships, and the pervasive effects of social isolation further compound this escalation. The pre-existing inequalities in access to and quality of care were accentuated during this crisis, with marginalized groups encountering heightened impediments to essential services. In navigating this unprecedented challenge, communities emerged as integral agents in establishing supportive networks and implementing culturally sensitive interventions. Technology, such as telemedicine and online resources, played a pivotal role in bridging access gaps, particularly in remote areas. The synthesis of best practices for supporting mental health patients during lockdowns encompasses targeted interventions for vulnerable groups, including adolescents and pregnant women. Empowering communities through economic support and mental health literacy programs was identified as crucial. The integration of technology, such as the development of robust telemedicine frameworks, virtual training in curricula, and the utilization of digital platforms for interventions and public messaging, emerged as a cornerstone in addressing access disparities. Community engagement and resilience-building strategies gained prominence, emphasizing the necessity of collaboration between healthcare providers and communities. Promotion of peer support groups, home-based care, and the preservation of traditional healing practices were underscored as essential components.

CONCLUSION

The study underscores the need to adapt and optimize mental health services during emergencies. This entails prioritizing mental health within emergency response frameworks, exploring alternative service delivery methods, and fortifying data collection and research efforts.