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

The Use of Social Media to Express and Manage Medical Uncertainty in Dyskeratosis Congenita: Content Analysis

BACKGROUND

Social media has the potential to provide social support for rare disease communities; however, little is known about the use of social media for the expression of medical uncertainty, a common feature of rare diseases.

OBJECTIVE

This study aims to evaluate the expression of medical uncertainty on social media in the context of dyskeratosis congenita, a rare cancer-prone inherited bone marrow failure and telomere biology disorder (TBD).

METHODS

We performed a content analysis of uncertainty-related posts on Facebook and Twitter managed by Team Telomere, a patient advocacy group for this rare disease. We assessed the frequency of uncertainty-related posts, uncertainty sources, issues, and management and associations between uncertainty and social support.

RESULTS

Across all TBD social media platforms, 45.98% (1269/2760) of posts were uncertainty related. Uncertainty-related posts authored by Team Telomere on Twitter focused on scientific (306/434, 70.5%) or personal (230/434, 53%) issues and reflected uncertainty arising from probability, ambiguity, or complexity. Uncertainty-related posts in conversations among patients and caregivers in the Facebook community group focused on scientific (429/511, 84%), personal (157/511, 30.7%), and practical (114/511, 22.3%) issues, many of which were related to prognostic unknowns. Both platforms suggested uncertainty management strategies that focused on information sharing and community building. Posts reflecting response-focused uncertainty management strategies (eg, emotional regulation) were more frequent on Twitter compared with the Facebook community group (χ21=3.9; P=.05), whereas posts reflecting uncertainty-focused management strategies (eg, ordering information) were more frequent in the Facebook community group compared with Twitter (χ21=55.1; P<.001). In the Facebook community group, only 36% (184/511) of members created posts during the study period, and those who created posts did so with a low frequency (median 3, IQR 1-7 posts). Analysis of post creator characteristics suggested that most users of TBD social media are White, female, and parents of patients with dyskeratosis congenita.

CONCLUSIONS

Although uncertainty is a pervasive and multifactorial issue in TBDs, our findings suggest that the discussion of medical uncertainty on TBD social media is largely limited to brief exchanges about scientific, personal, or practical issues rather than ongoing supportive conversation. The nature of uncertainty-related conversations also varied by user group: patients and caregivers used social media primarily to discuss scientific uncertainties (eg, regarding prognosis), form social connections, or exchange advice on accessing and organizing medical care, whereas Team Telomere used social media to express scientific and personal issues of uncertainty and to address the emotional impact of uncertainty. The higher involvement of female parents on TBD social media suggests a potentially greater burden of uncertainty management among mothers compared with other groups. Further research is needed to understand the dynamics of social media engagement to manage medical uncertainty in the TBD community.

Acquiring Social Support in an Online HPV Support Group: Exploring the Roles of Threat and Efficacy

Social media have become crucial communication channels for human papilloma virus (HPV) patients to seek and receive social support that can benefit their physical and psychological health. To promote supportive communication on online social platforms, we analyzed 96,543 messages, including 7,407 posts and 89,136 comments, concerning social support on Baidu HPV Forum, one of China's largest online HPV support groups. We examined factors (i.e., threat and efficacy) in posts requesting social support associated with the amount of social support received in comments. Results revealed that the majority of social support messages received in comments represented informational support, whereas relatively few comments featured instrumental social support. Beyond that, high-threat, non-efficacy posts requesting social support received a greater amount of informational and emotional support in the comments than other types of posts requesting social support. Theoretical and practical implications of our study are discussed as well.

Use of Social Media for Health Advocacy for Digital Communities: Descriptive Study

BACKGROUND

There has been a growth surge in the use of social media among individuals today. The widespread adoption of these platforms, coupled with their engaging features, presents a unique opportunity for the dissemination of health advocacy information. Social media is known as a powerful tool used to share health policy and advocacy efforts and disseminate health information to digital community members and networks. Yet, there is still a gap in the full exploitation of this powerful instrument, among health care professionals, for health advocacy campaigns.

OBJECTIVE

This paper aims to describe the process of mobilizing social media platforms such as Twitter (rebranded to X Corp in 2023) for health advocacy of the digital community. Additionally, it aims to share the lessons and insights gained during this digital health advocacy engagement process.

METHODS

We performed a comprehensive review of Twitter analytical data to examine the impact of our social media posts. We then consolidated these analytic reports with our meeting logs to describe our systematic, iterative, and collaborative design process to implement social media efforts and generate key lessons learned.

RESULTS

Our review of monthly Twitter analytical reports and regular team meeting logs revealed several themes for successful and less successful practices in relation to our social media-based health advocacy efforts. The successful practices noted by the team included using personable, picture-based tweets; using a series of posts on a particular topic rather than an isolated post; leveraging team members' and partners' collaborations in shared posts; incorporating hashtags in tweets; using a balanced mix of texts and graphics in posts; using inclusive (nondestigmatizing) languages in tweeted posts; and use of polls to share tweets. Among the many lessons learned, we also experienced limitations including a lack of comprehensive statistics on Twitter usage for health care-related purposes such as health advocacy and limits in collating the estimates of the actual impact made on the intended digital community members by our posts.

CONCLUSIONS

Twitter has been successfully used in promoting health advocacy content, and the social media team aims to explore other social media platforms that have a wider reach than Twitter. We will continue making necessary adjustments in strategies, techniques, and styles to engage the audience as we expand onto new platforms like Instagram and TikTok for health advocacy promotions.

What makes an online help-seeking message go far during the COVID-19 crisis in mainland China? A multilevel regression analysis

Various studies have explored the underlying mechanisms that enhance the overall reach of a support-seeking message on social media networks. However, little attention has been paid to an under-examined structural feature of help-seeking message diffusion, information diffusion depth, and how support-seeking messages can traverse vertically into social media networks to reach other users who are not directly connected to the help-seeker. Using the multilevel regression to analyze 705 help-seeking posts regarding COVID-19 on Sina Weibo, we examined sender, content, and environmental factors to investigate what makes help-seeking messages traverse deeply into social media networks. Results suggested that bandwagon cues, anger, instrumental appeal, and intermediate self-disclosure facilitate the diffusion depth of help-seeking messages. However, the effects of these factors were moderated by the epidemic severity. Implications of the findings on support-seeking behavior and narrative strategies on social media were also discussed.

Support-Seeking Strategies and Social Support Provided in Chinese Online Health Communities Related to COVID-19

Online health communities have become one of the most important means for people to seek social support during the coronavirus 2019 disease (COVID-19) pandemic. This study details content analysis of support-seeking strategies and social support offered on the online forum "Baidu COVID-19bar" across different stages of initial stage as well as during the entire initial stage of the COVID-19 pandemic. The results show that asking for support and disclosing directly were the main strategies used across the different stages and during the entire initial stage. Informational support and emotional support were the most common types sought in the first two stages and the entire initial stage, and informational support was the main type during the decline stage. Furthermore, asking for support was more likely to elicit informational support while disclosing directly was more likely to elicit emotional support. Theoretical and practical implications of the findings are discussed.