The effects of Facebook and Instagram on the 2020 election: A deactivation experiment.

We study the effect of Facebook and Instagram access on political beliefs, attitudes, and behavior by randomizing a subset of 19,857 Facebook users and 15,585 Instagram users to deactivate their accounts for 6 wk before the 2020 U.S. election. We report four key findings. First, both Facebook and Instagram deactivation reduced an index of political participation (driven mainly by reduced participation online). Second, Facebook deactivation had no significant effect on an index of knowledge, but secondary analyses suggest that it reduced knowledge of general news while possibly also decreasing belief in misinformation circulating online. Third, Facebook deactivation may have reduced self-reported net votes for Trump, though this effect does not meet our preregistered significance threshold. Finally, the effects of both Facebook and Instagram deactivation on affective and issue polarization, perceived legitimacy of the election, candidate favorability, and voter turnout were all precisely estimated and close to zero.

Sharing of misinformation is habitual, not just lazy or biased.

Why do people share misinformation on social media? In this research (N = 2,476), we show that the structure of online sharing built into social platforms is more important than individual deficits in critical reasoning and partisan bias-commonly cited drivers of misinformation. Due to the reward-based learning systems on social media, users form habits of sharing information that attracts others' attention. Once habits form, information sharing is automatically activated by cues on the platform without users considering response outcomes such as spreading misinformation. As a result of user habits, 30 to 40% of the false news shared in our research was due to the 15% most habitual news sharers. Suggesting that sharing of false news is part of a broader response pattern established by social media platforms, habitual users also shared information that challenged their own political beliefs. Finally, we show that sharing of false news is not an inevitable consequence of user habits: Social media sites could be restructured to build habits to share accurate information.

A protocol for harvesting biodiversity data from Facebook.

The expanding use of community science platforms has led to an exponential increase in biodiversity data in global repositories. Yet, understanding of species distributions remains patchy. Biodiversity data from social media can potentially reduce the global biodiversity knowledge gap. However, practical guidelines and standardized methods for harvesting such data are nonexistent. Following data privacy and protection safeguards, we devised a standardized method for extracting species distribution records from Facebook groups that allow access to their data. It involves 3 steps: group selection, data extraction, and georeferencing the record location. We present how to structure keywords, search for species photographs, and georeference localities for such records. We further highlight some challenges users might face when extracting species distribution data from Facebook and suggest solutions. Following our proposed framework, we present a case study on Bangladesh's biodiversity-a tropical megadiverse South Asian country. We scraped nearly 45,000 unique georeferenced records across 967 species and found a median of 27 records per species. About 12% of the distribution data were for threatened species, representing 27% of all species. We also obtained data for 56 DataDeficient species for Bangladesh. If carefully harvested, social media data can significantly reduce global biodiversity knowledge gaps. Consequently, developing an automated tool to extract and interpret social media biodiversity data is a research priority.

Un protocolo para recolectar datos sobre biodiversidad en Facebook Resumen El uso creciente de plataformas de ciencia comunitaria ha causado un incremento exponencial de los datos sobre biodiversidad en los repositorios mundiales. Sin embargo, el conocimiento sobre la distribución de las especies todavía está incompleto. Los datos sobre biodiversidad obtenidos de las redes sociales tienen el potencial para disminuir el vacío de conocimiento sobre la biodiversidad mundial. No obstante, no existe una guía práctica o un método estandarizado para recolectar dichos datos. Seguimos los protocolos de privacidad y protección de datos para diseñar un método estandarizado para extraer registros de la distribución de especies de grupos en Facebook que permiten el acceso a sus datos. El método consta de tres pasos: selección del grupo, extracción de datos y georreferenciación de la localidad registrada. También planteamos cómo estructurar las palabras clave, buscar fotografías de especies y georreferenciar las localidades de dichos registros. Además, resaltamos algunos retos que los usuarios pueden enfrentar al extraer los datos de distribución de Facebook y sugerimos algunas soluciones. Aplicamos nuestro marco de trabajo propuesto a un estudio de caso de la biodiversidad en Bangladesh, un país tropical megadiverso en el sureste de Asia. Reunimos casi 45,000 registros georreferenciados únicos para 967 especies y encontramos una media de 27 registros por especie. Casi el 12% de los datos de distribución correspondió a especies amenazadas, que representaban el 27% de todas las especies. También obtuvimos datos para 56 especies deficientes de datos en Bangladesh. Si los datos de las redes sociales se recolectan con cuidado, éstos pueden reducir de forma significativa el vacío de conocimiento para la biodiversidad mundial. Como consecuencia, es una prioridad para la investigación el desarrollo de una herramienta automatizada para extraer e interpretar los datos sobre biodiversidad de las redes sociales.

Exposing illegal hunting and wildlife depletion in the world's largest tropical country through social media data.

Globally, illegal sport hunting can threaten prey populations when unregulated. Due to its covert nature, illegal sport hunting poses challenges for data collection, hindering efforts to understand the full extent of its impacts. We gathered social media data to analyze patterns of illegal sport hunting and wildlife depletion across Brazil. We collected data for 2 years (2018-2020) across 5 Facebook groups containing posts depicting pictures of illegal sport hunting events of native fauna. We described and mapped these hunting events by detailing the number of hunters involved, the number of species, the mean body mass of individuals, and the number and biomass of individuals hunted per unit area, stratified by Brazilian biome. We also examined the effects of defaunation on hunting yield and composition via regression models, rank-abundance curves, and spatial interpolation. We detected 2046 illegal sport hunting posts portraying the hunting of 4658 animals (∼29 t of undressed meat) across all 27 states and 6 natural biomes of Brazil. Of 157 native species targeted by hunters, 19 are currently threatened with extinction. We estimated that 1414 hunters extracted 3251 kg/million km2. Some areas exhibited more pronounced wildlife depletion, in particular the Atlantic Forest and Caatinga biomes. In these areas, there was a shift from large mammals and reptiles to small birds as the main targeted taxa, and biomass extracted per hunting event and mean body mass across all taxonomic groups were lower than in other areas. Our results highlight that illegal sport hunting adds to the pressures of subsistence hunting and the wild meat trade on Brazil's wildlife populations. Enhanced surveillance efforts are needed to reduce illegal sport hunting levels and to develop well-managed sustainable sport hunting programs. These can support wildlife conservation and offer incentives for local communities to oversee designated sport hunting areas.

Exposición de la caza ilegal y la reducción de fauna en el país tropical más grande del mundo por medio de datos de las redes sociales Resumen En todo el mundo, la caza recreativa ilegal puede amenazar a las poblaciones de presas cuando no está regulada. Debido a su naturaleza encubierta, la caza recreativa ilegal plantea dificultades para la recopilación de datos, lo que dificulta la comprensión de su impacto. Recopilamos datos de redes sociales para analizar los patrones de caza recreativa ilegal y agotamiento de la vida silvestre en todo Brasil. Recopilamos datos durante 2 años (2018­2020) a través de cinco grupos de Facebook que contenían publicaciones que mostraban imágenes de eventos de caza recreativa ilegal de fauna nativa. Describimos y mapeamos estos eventos de caza detallando el número de cazadores involucrados, el número de especies, la masa corporal media de los individuos y el número y la biomasa de los individuos cazados por unidad de área, estratificados por bioma brasileño. También examinamos los efectos de la deforestación en el rendimiento y la composición de la caza mediante modelos de regresión, curvas de abundancia e interpolación espacial. Detectamos 2,046 puestos de caza recreativa ilegal que mostraban la caza de 4,658 animales (∼29 t de carne sin desollar) en los 27 estados y 6 biomas naturales de Brasil. De las 157 especies autóctonas objetivo de los cazadores, 18 están actualmente en peligro de extinción. Se calcula que 1,414 cazadores extrajeron 3,251 kg/millón de km2. Algunas zonas mostraron una defaunación más pronunciada, en particular los biomas de la Mata Atlántica y la Caatinga. En estas áreas, se produjo un cambio de grandes mamíferos y reptiles a pequeñas aves como principales taxones objetivo, y la biomasa extraída por evento de caza y la masa corporal media en todos los grupos taxonómicos fueron menores que en otras áreas. Nuestros resultados ponen de manifiesto que la caza recreativa ilegal se suma a las presiones de la caza de subsistencia y el comercio de carne salvaje sobre las poblaciones de fauna de Brasil. Es necesario intensificar los esfuerzos de vigilancia para reducir los niveles de caza recreativa ilegal y desarrollar programas de caza recreativa sostenibles y bien gestionados. Estos programas pueden contribuir a la conservación de la fauna y ofrecer incentivos a las comunidades locales para que supervisen las zonas designadas para la caza recreativa.

Unauthentic Information About Celiac Disease on Social Networking Pages: Is It a Matter of Concern in Celiac Disease Management?

BACKGROUND: Facebook (FB) is the most popular online networking platform. Many celiac disease Facebook (CD-FB) pages spread awareness about celiac disease (CD). To get the latest information, patients with CD frequently follow such pages. However, little is known about whether such pages provide authentic and reliable information. AIMS: This study aims to investigate whether CD-FB pages spread misleading information to patients with CD. METHODS: On the Facebook social networking platform, CD-FB pages created in three celiac-prevalent countries (Italy, the USA, and India) were explored using different combinations of keywords. The type/category of the CD-FB page, country of origin, purpose, page web link, and number of followers/members were documented in a Microsoft spreadsheet. All posts distributed on selected CD-FB pages in the last 3 years were thoroughly screened. RESULTS: From August 2022 to March 2023, a total of 200 CD-FB pages from Italy, the USA, and India were explored. Out of these 200 pages, 155 CD-FB (Italy 70; the USA 46; India 39) were found eligible. Of them, 20 (13%) CD-FB pages (Italy 4; the USA 5; India 11) shared misleading information about CD. Surprisingly, 11 (8%) of these 20 pages (Italy 0; the USA 2; India 9) supported alternative treatment options for CD. CONCLUSIONS: CD-FB pages are useful for disseminating celiac-disease-related information. While most such pages provide useful information, 13% of CD-FB pages allow misleading information. Patients with CD should consult their treating unit before following any uncertain information posted on CD-FB pages.

Recruiting refugees to reduce labour shortages in health care professions: experimental evidence on the potential of foreign-language outreach on social media.

BACKGROUND: Many high-income countries are grappling with severe labour shortages in the healthcare sector. Refugees and recent migrants present a potential pool for staff recruitment due to their higher unemployment rates, younger age, and lower average educational attainment compared to the host society's labour force. Despite this, refugees and recent migrants, often possessing limited language skills in the destination country, are frequently excluded from traditional recruitment campaigns conducted solely in the host country's language. Even those with intermediate language skills may feel excluded, as destination-country language advertisements are perceived as targeting only native speakers. This study experimentally assesses the effectiveness of a recruitment campaign for nursing positions in a German care facility, specifically targeting Arabic and Ukrainian speakers through Facebook advertisements. METHODS: We employ an experimental design (AB test) approximating a randomized controlled trial, utilizing Facebook as the delivery platform. We compare job advertisements for nursing positions in the native languages of Arabic and Ukrainian speakers (treatment) with the same advertisements displayed in German (control) for the same target group in the context of a real recruitment campaign for nursing jobs in Berlin, Germany. Our evaluation includes comparing link click rates, visits to the recruitment website, initiated applications, and completed applications, along with the unit cost of these indicators. We assess statistical significance in group differences using the Chi-squared test. RESULTS: We find that recruitment efforts in the origin language were 5.6 times (Arabic speakers) and 1.9 times (Ukrainian speakers) more effective in initiating nursing job applications compared to the standard model of German-only advertisements among recent migrants and refugees. Overall, targeting refugees and recent migrants was 2.4 (Ukrainians) and 10.8 (Arabic) times cheaper than targeting the reference group of German speakers indicating higher interest among these groups. CONCLUSIONS: The results underscore the substantial benefits for employers in utilizing targeted recruitment via social media aimed at foreign-language communities within the country. This strategy, which is low-cost and low effort compared to recruiting abroad or investing in digitalization, has the potential for broad applicability in numerous high-income countries with sizable migrant communities. Increased employment rates among underemployed refugee and migrant communities, in turn, contribute to reducing poverty, social exclusion, public expenditure, and foster greater acceptance of newcomers within the receiving society.

Assessing the impact of small firm dynamics on public mental health amid the pandemic in Latin America.

OBJECTIVE: The aim of our study is to examine the relationship between the economic activity of small firms and the mental well-being of the population in five Latin American countries in the early stages of the pandemic. METHODS: We utilize the search volume of certain keywords on Google Trends (GT), such as "boredom," "frustration," "loneliness," "sleep", "anxiety", and "depression", as an indicator of the well-being of the population. By examining the data from Facebook Business Activity Trends, we investigate how social attention reacts to the activity levels of different economic sectors. RESULTS: Increased business activity is generally associated with reduced levels of boredom, loneliness, sleep problems and anxiety. The effect on depression varies by sector, with positive associations concentrated in onsite jobs. In addition, we observe that strict Non-Pharmaceutical Interventions (NPIs) tend to exacerbate feelings of boredom and loneliness, sleep issues, and anxiety. CONCLUSIONS: Our findings suggest a strong association between different indicators of psychological well-being and the level of activity in different sectors of the economy. Given the essential role of small and medium-sized enterprises (SMEs) in generating employment, especially during crises like the pandemic, it is imperative that they remain resilient and adaptable to support economic recovery and job preservation. To accomplish this, policymakers need to focus on providing financial stability and support for SMEs, fostering social support networks within companies, and incorporating mental health services into workplace environments. This comprehensive strategy can alleviate mental health challenges and enhance public health resilience.

The role of social media in public health awareness during times of war in Sudan: snakebites and scorpion stings.

BACKGROUND: Snakebite envenomation (SBE) and scorpion sting envenomation (SSE) are significant neglected tropical diseases that primarily affect impoverished communities in rural areas of developing nations. A lack of understanding about snake and scorpion species and their distribution exacerbates the disabilities and fatalities caused by SBE and SSE. In Sudan, particularly in regions affected by ongoing conflicts where healthcare resources are scarce, social media platforms offer a cost-effective approach to addressing public health challenges. Our aim in this study is to highlight the benefits of using social media for data collection and health promotion in such environments. METHODS: We present a cost-effective communication and data collection strategy implemented at the Toxic Organisms Research Centre (TORC) of the University of Khartoum, focusing on a Facebook group, "Scorpions and Snakes of Sudan", as our primary social media platform. Additionally, we discuss the lessons learned and the initial impact of this strategy on enhancing population health literacy. RESULTS: The group community is composed of ~ 5000 members from 14 countries. During the period from January 2023 to January 2024, we received 417 enquiries about snakes and scorpions belonging to 11 families and composed of 55 species. In addition, 53 other enquiries covered a range of organisms and their tracks (e.g., spiders, skinks, chameleons, foxes, sun spiders, centipedes, lizards, moth larvae, and insect tracks). The first photographic evidence of Malpolon monspessulanus in Sudan was via the group activities. The rare species Telescopus gezirae, the Blue Nile cat snake, is also documented via the group member's queries. Recognizing the evolving nature of social media use in public health, we also address the current limitations and evidence gaps that need to be addressed to effectively translate best practices into policy. CONCLUSION: In conclusion, utilizing Facebook as an institutional platform to share scientific information in simple Arabic language underscores the proactive roles that citizens, scientists, and public health stakeholders can play in leveraging social media for eHealth, eAwareness, and public health initiatives. This approach highlights the potential for collaborative efforts, particularly during crises, to maximize the benefits of social media in advancing public health.

Does Including Facebook Training Improve the Effectiveness of Computerized Cognitive Training? A Randomized Controlled Trial.

OBJECTIVE: To determine whether implementing a Facebook training program improves the effectiveness of computerized cognitive training (CCT) in older adults. DESIGN: Randomized, controlled, double single-blind trial with parallel groups. SETTING: Community centers. SUBJECTS: Eighty-six adults between 60 and 90 years old. INTERVENTIONS: Nine face-to-face 60-min sessions of CCT with VIRTRAEL for all participants. The experimental group received an additional 30 min of Facebook training per session. MAIN MEASURES: Attention (d2 Test of Attention); learning and verbal memory (Hopkins Verbal Learning Test-Revised); working memory (Letter-Number Sequencing test), semantic and abstract reasoning (Similarities and Matrix Reasoning tests); and planning (Key Search test). RESULTS: There was a significant Group*Time interaction in the Hopkins Verbal Learning Test-Revised-Trial 3, Letter-Number sequencing, and Matrix tests. Between groups, post-hoc analyses showed a difference in Matrix reasoning (p < .001; d = 0.893) at post-intervention in favor of the experimental group. Significant main effects of time were found in the CCT group between baseline and 3-month follow-up for Concentration (F = 26.431, p ≤ .001), Letters and Numbers (F = 30.549, p ≤ .001), Learning (F = 38.678, p ≤ .001), Similarities (F = 69.885, p ≤ .001), Matrix (F = 90.342, p ≤ .001), and Key Search (F = 7.904, p = .006) tests. CONCLUSIONS: The utilization of CCT with VIRTRAEL, a freely accessible tool with broad applicability, resulted in enhanced attention, verbal learning, working memory, abstract and semantic reasoning, and planning among older adults. These improvements were sustained for at least three months post-training. Additional training in Facebook did not enhance the effectiveness of CCT.

Exploring the information needs of patients with osteoarthritis of the knee: a content analysis of Facebook group posts.

BACKGROUND: End-stage osteoarthritis of the knee (OAK) is often treated by total knee arthroplasty (TKA). This intervention can significantly improve quality of life. However, many patients are dissatisfied with the outcome of surgery. One of the factors related to dissatisfaction is the of lack integration of patients' preferences, habits and values that are not addressed by physicians. To develop realistic expectations, affected patients need evidence-based information. Our aim was to explore the information needs of patients with OAK to support the development of decision aids and consent forms to promote informed decision-making. Additionally, we investigated whether the information needs during the Covid-19 pandemic differ from those before the pandemic. METHODS: The qualitative research design included a social media analysis of Facebook groups. Facebook groups were selected according to the following criteria: Thematic relevance, English or German language, at least one new post per week, from period before and after the start of the Covid-19 pandemic in March 2020. Thematically relevant group posts were analysed according to the content-structuring content analysis of Kuckartz using MaxQDA. RESULTS: Out of 448 identified Facebook groups, we screened seven for relevant posts and a total of 77 posts out of 6 groups were selected. The following eight categories were derived during the coding process: access to health care, disease information, TKA indication and contraindication, TKA outcome and quality of life, information needs regarding conservative therapy, strain, attitude towards TKA and attitude towards conservative therapy. The analysis showed that patients with OAK need information about the benefits and risks of TKA and conservative therapies. CONCLUSION: This study provides information on the information needs of patients with OAK in order to decide between TKA or conservative therapy. Patients need information about treatment options in due consideration of their immediate living situation to be reliably able to assess potential outcomes. Such Information about TKA should enable patients to assess the individual prognosis with comprehensible and relevant outcome measures. Also, they should be formulated with the living environment of the patients in mind and be linked to possible fears and negative previous experiences with treatments.

News Coverage of the COVID-19 Pandemic on Social Media and the Public's Negative Emotions: Computational Study.

BACKGROUND: Social media has become an increasingly popular and critical tool for users to digest diverse information and express their perceptions and attitudes. While most studies endeavor to delineate the emotional responses of social media users, there is limited research exploring the factors associated with the emergence of emotions, particularly negative ones, during news consumption. OBJECTIVE: We aim to first depict the web coverage by news organizations on social media and then explore the crucial elements of news coverage that trigger the public's negative emotions. Our findings can act as a reference for responsible parties and news organizations in times of crisis. METHODS: We collected 23,705 Facebook posts with 1,019,317 comments from the public pages of representative news organizations in Hong Kong. We used text mining techniques, such as topic models and Bidirectional Encoder Representations from Transformers, to analyze news components and public reactions. Beyond descriptive analysis, we used regression models to shed light on how news coverage on social media is associated with the public's negative emotional responses. RESULTS: Our results suggest that occurrences of issues regarding pandemic situations, antipandemic measures, and supportive actions are likely to reduce the public's negative emotions, while comments on the posts mentioning the central government and the Government of Hong Kong reveal more negativeness. Negative and neutral media tones can alleviate the rage and interact with the subjects and issues in the news to affect users' negative emotions. Post length is found to have a curvilinear relationship with users' negative emotions. CONCLUSIONS: This study sheds light on the impacts of various components of news coverage (issues, subjects, media tone, and length) on social media on the public's negative emotions (anger, fear, and sadness). Our comprehensive analysis provides a reference framework for efficient crisis communication for similar pandemics at present or in the future. This research, although first extending the analysis between the components of news coverage and negative user emotions to the scenario of social media, echoes previous studies drawn from traditional media and its derivatives, such as web newspapers. Although the era of COVID-19 pandemic gradually brings down the curtain, the commonality of this research and previous studies also contributes to establishing a clearer territory in the field of health crises.

Acceptance of Social Media Recruitment for Clinical Studies Among Patients With Hepatitis B: Mixed Methods Study.

BACKGROUND: Social media platforms are increasingly used to recruit patients for clinical studies. Yet, patients' attitudes regarding social media recruitment are underexplored. OBJECTIVE: This mixed methods study aims to assess predictors of the acceptance of social media recruitment among patients with hepatitis B, a patient population that is considered particularly vulnerable in this context. METHODS: Using a mixed methods approach, the hypotheses for our survey were developed based on a qualitative interview study with 6 patients with hepatitis B and 30 multidisciplinary experts. Thematic analysis was applied to qualitative interview analysis. For the cross-sectional survey, we additionally recruited 195 patients with hepatitis B from 3 clinical centers in Germany. Adult patients capable of judgment with a hepatitis B diagnosis who understood German and visited 1 of the 3 study centers during the data collection period were eligible to participate. Data analysis was conducted using SPSS (version 28; IBM Corp), including descriptive statistics and regression analysis. RESULTS: On the basis of the qualitative interview analysis, we hypothesized that 6 factors were associated with acceptance of social media recruitment: using social media in the context of hepatitis B (hypothesis 1), digital literacy (hypothesis 2), interest in clinical studies (hypothesis 3), trust in nonmedical (hypothesis 4a) and medical (hypothesis 4b) information sources, perceiving the hepatitis B diagnosis as a secret (hypothesis 5a), attitudes toward data privacy in the social media context (hypothesis 5b), and perceived stigma (hypothesis 6). Regression analysis revealed that the higher the social media use for hepatitis B (hypothesis 1), the higher the interest in clinical studies (hypothesis 3), the more trust in nonmedical information sources (hypothesis 4a), and the less secrecy around a hepatitis B diagnosis (hypothesis 5a), the higher the acceptance of social media as a recruitment tool for clinical hepatitis B studies. CONCLUSIONS: This mixed methods study provides the first quantitative insights into social media acceptance for clinical study recruitment among patients with hepatitis B. The study was limited to patients with hepatitis B in Germany but sets out to be a reference point for future studies assessing the attitudes toward and acceptance of social media recruitment for clinical studies. Such empirical inquiries can facilitate the work of researchers designing clinical studies as well as ethics review boards in balancing the risks and benefits of social media recruitment in a context-specific manner.

Assessing Message Deployment During Public Health Emergencies Through Social Media: Empirical Test of Optimizing Content for Effective Dissemination.

BACKGROUND: During an infodemic, timely, reliable, and accessible information is crucial to combat the proliferation of health misinformation. While message testing can provide vital information to make data-informed decisions, traditional methods tend to be time- and resource-intensive. Recognizing this need, we developed the rapid message testing at scale (RMTS) approach to allow communicators to repurpose existing social media advertising tools and understand the full spectrum of audience engagement. OBJECTIVE: We had two main objectives: (1) to demonstrate the use of the RMTS approach for message testing, especially when resources and time are limited, and (2) to propose and test the efficacy of an outcome variable that measures engagement along a continuum of viewing experience. METHODS: We developed 12 versions of a single video created for a vaccine confidence project in India. We manipulated video length, aspect ratio, and use of subtitles. The videos were tested across 4 demographic groups (women or men, younger or older). We assessed user engagement along a continuum of viewing experience: obtaining attention, sustaining attention, conveying the message, and inspiring action. These were measured by the percentage of video watched and clicks on the call-to-action link. RESULTS: The video advertisements were placed on Facebook for over 4 consecutive days at the cost of US $450 and garnered a total of 3.34 million impressions. Overall, we found that the best-performing video was the shorter version in portrait aspect ratio and without subtitles. There was a significant but small association between the length of the video and users' level of engagement at key points along the continuum of viewing experience (N=1,032,888; χ24=48,261.97; P<.001; V=.22). We found that for the longer video, those with subtitles held viewers longer after 25% video watch time than those without subtitles (n=15,597; χ21=7.33; P=.007; V=.02). While we found some significant associations between the aspect ratio, the use of subtitles, and the number of users watching the video and clicking on the call-to-action link, the effect size for those were extremely small. CONCLUSIONS: This test served as a proof of concept for the RMTS approach. We obtained rapid feedback on formal message attributes from a very large sample. The results of this test reinforce the need for platform-specific tailoring of communications. While our data showed a general preference for a short video in portrait orientation and without subtitles among our target audiences on Facebook, that may not necessarily be the case in other social media platforms such as YouTube or TikTok, where users go primarily to watch videos. RMTS testing highlights nuances that communication professionals can address instead of being limited to a "one size fits all" approach.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

BACKGROUND: Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. OBJECTIVE: This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. METHODS: This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. RESULTS: The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. CONCLUSIONS: The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). TRIAL REGISTRATION: ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

Strategies for Identifying and Recruiting Women at High Risk for Breast Cancer for Research Outside of Clinical Settings: Observational Study.

BACKGROUND: Research is needed to understand and address barriers to risk management for women at high (≥20% lifetime) risk for breast cancer, but recruiting this population for research studies is challenging. OBJECTIVE: This paper compares a variety of recruitment strategies used for a cross-sectional, observational study of high-risk women. METHODS: Eligible participants were assigned female at birth, aged 25-85 years, English-speaking, living in the United States, and at high risk for breast cancer as defined by the American College of Radiology. Individuals were excluded if they had a personal history of breast cancer, prior bilateral mastectomy, medical contraindications for magnetic resonance imaging, or were not up-to-date on screening mammography per American College of Radiology guidelines. Participants were recruited from August 2020 to January 2021 using the following mechanisms: targeted Facebook advertisements, Twitter posts, ResearchMatch (a web-based research recruitment database), community partner promotions, paper flyers, and community outreach events. Interested individuals were directed to a secure website with eligibility screening questions. Participants self-reported method of recruitment during the eligibility screening. For each recruitment strategy, we calculated the rate of eligible respondents and completed surveys, costs per eligible participant, and participant demographics. RESULTS: We received 1566 unique responses to the eligibility screener. Participants most often reported recruitment via Facebook advertisements (724/1566, 46%) and ResearchMatch (646/1566, 41%). Community partner promotions resulted in the highest proportion of eligible respondents (24/46, 52%), while ResearchMatch had the lowest proportion of eligible respondents (73/646, 11%). Word of mouth was the most cost-effective recruitment strategy (US $4.66 per completed survey response) and paper flyers were the least cost-effective (US $1448.13 per completed survey response). The demographic characteristics of eligible respondents varied by recruitment strategy: Twitter posts and community outreach events resulted in the highest proportion of Hispanic or Latina women (1/4, 25% and 2/6, 33%, respectively), and community partner promotions resulted in the highest proportion of non-Hispanic Black women (4/24, 17%). CONCLUSIONS: Although recruitment strategies varied in their yield of study participants, results overall support the feasibility of identifying and recruiting women at high risk for breast cancer outside of clinical settings. Researchers must balance the associated costs and participant yield of various recruitment strategies in planning future studies focused on high-risk women.

Current insights on social media as a tool for the dissemination of research and education in surgery: a narrative review.

The purpose of our narrative review is to summarize the utilization of social media (SoMe) platforms for research communication within the field of surgery. We searched the PubMed database for articles in the last decade that discuss the utilization of SoMe in surgery and then categorized the diverse purposes of SoMe. SoMe proved to be a powerful tool for disseminating articles. Employing strategic methods like visual abstracts enhances article citation rates, the impact factor, h-index, and Altmetric score (an emerging alternative metric that comprehensively and instantly quantifies the social impact of scientific papers). SoMe also proved valuable for surgical education, with online videos shared widely for surgical training. However, it is essential to acknowledge the associated risk of inconsistency in quality. Moreover, SoMe facilitates discussion on specific topics through hashtags or closed groups and is instrumental in recruiting surgeons, with over half of general surgery residency programs in the US efficiently leveraging these platforms to attract the attention of potential candidates. Thus, there is a wealth of evidence supporting the effective use of SoMe for surgeons. In the contemporary era where SoMe is widely utilized, surgeons should be well-versed in this evidence.

Comparing the educational quality of YouTube and Facebook videos on tympanostomy tubes.

PURPOSE: Patients often refer to online materials when researching surgical procedures. This study compares the educational quality of online videos about tympanostomy tubes on two popular video platforms: YouTube and Facebook. This study provides clinicians with context about the content and quality of information patients may possess after watching online videos on tympanostomy tubes. MATERIALS AND METHODS: YouTube and Facebook were searched using key terms related to tympanostomy tubes. Videos were screened and scored in triplicate. DISCERN quality, content, production, and alternative medicine scores were assigned. Statistical analysis was conducted using GraphPad Prism. RESULTS: 76 YouTube and 86 Facebook videos were analyzed. DISCERN quality scores (mean = 1.8 vs. 1.4, P < .0001), content scores (mean = 1.7 vs. 1.0, P < .0001), and production scores (mean = 4.8 vs. 4.6, P = .0327) were significantly higher on YouTube compared to Facebook. 33 % of Facebook videos referenced alternative medicine, as compared with 0 % of YouTube videos (P < .0001). Physician/hospital-generated videos had significantly higher DISCERN and content scores than parent-, product-, and chiropractor-generated videos. Views did not correlate with DISCERN or content scores. CONCLUSION: YouTube is a better platform than Facebook for educational videos about tympanostomy tubes. YouTube videos had higher educational quality, more comprehensive content, and less alternative medicine. One third of Facebook videos advocated for alternative treatments. Importantly, videos on both platforms were of limited educational quality as demonstrated through low DISCERN reliability scores and coverage of few important content areas.

Concerns regarding health-related social media usage amongst otolaryngology patients.

PURPOSE: The objective of this study was to determine concerns of otolaryngology patients regarding health-related social media usage. METHODS: A total of 372 otolaryngology patients were asked to report their level of concern (on a scale of "not at all", "a little", "somewhat", or "highly" concerned) regarding health-related social media usage as it pertained to risk of "loss of privacy or anonymity related to your health condition", "reliability of disease/treatment information", and "reliability of physician reviews/recommendations". Demographics and social media usage patterns (on Facebook, Instagram, Twitter, TikTok or other platforms) were compared to concerns about health-related social media usage. RESULTS: The level of concern was highest for reliability of disease/treatment information and least for loss of privacy/anonymity (p < 0.001). Concern about loss of privacy/anonymity was associated with age over 25 years (OR = 3.12, 95%CI 1.66-5.86, p < 0.001) and negatively with daily use of Twitter (OR = 0.54, 95%CI 0.30-0.96, p = 0.035). Concern about reliability of disease/treatment information was negatively associated with Medicare insurance (OR = 0.57, 95%CI 0.35-0.93, p = 0.024), which is available to adults aged ≥65 years, and concern over reliability of physician reviews/recommendations was associated with patients identifying their race as Asian, American Indian and other (OR = 3.16, 95%CI 1.22-8.19, p = 0.018). CONCLUSIONS: The greatest concern about health-related social media usage is related to reliability of disease/treatment information, though notably less among patients with Medicare who represent adults of age 65 years or older. Concerns over loss of privacy/anonymity and reliability of physician reviews/recommendations are also prevalent and associated with patient demographics. These concerns may constrain utilization of social media for healthcare purposes, which highlights the importance of reliable sources of information.

Leveraging the use of a social media app as a collaborative medical information and knowledge sharing tool-insights from experiential use and survey of a CME WhatsApp community.

BACKGROUND AND AIM: Continuing Medical Education (CME) is crucial for physicians to stay current in the rapidly advancing field of medicine. A WhatsApp (WA) based community of physicians was initiated in 2016 'WhatsApp CME India Group' to facilitate learning, knowledge sharing, and discussion among physicians. Due to participant size constraints of the technology, it evolved into seven distinct WA groups, overseen by a central administrator. A survey undertaken in the group's 7th year aimed to evaluate its effectiveness in achieving its goals, measure participant engagement, and uncover the primary factors driving its usage. METHODS: The survey questionnaire was distributed to 3500 members across the 07 WhatsApp CME groups for voluntary participation. Data collected was analysed using SPSS version 24.0 (SPSS Inc., Chicago, IL, USA) and reported using descriptive statistics. RESULTS: Among the 581 survey respondents, the study found 43% of physicians use the WhatsApp academic groups for CME content, with 32% accessing their group over four times daily. The primary motivation for 77% was to discuss challenging cases and to gain knowledge updates from fellow physician (70%). Medical websites (57%), referral books (49%), and Google (43%) were other significant resources. Every participant (100%) found the WhatsApp CME India group the most beneficial resource for daily medical science updates. A significant portion (57%) of the respondents found the group valuable for real-time information exchange. Over 78% stated it kept them current with knowledge and guidelines. Notably, 94% viewed WhatsApp CME as complementary to physical conferences, not a replacement. The post-conference/webinar summaries were appreciated by 81% participants. Case discussions (31%) and update posts from fellow physicians sharing their insights and learnings (24%) were noted as activities of great academic interest. CONCLUSION: This study underscores the potential of digital platforms like WhatsApp in supplementing CME in India and potentially other comparable settings. The blend of digital and traditional resources suggests a balanced learning approach. While real-time engagement is a strength, challenges like information overload and privacy concerns require careful management. Striking a balance is crucial for ensuring content quality, structured discussions and privacy. As the digital age advances, professionals must critically assess shared information on these platforms to guarantee evidence-based and reliable knowledge dissemination. TRIAL REGISTRATION: ARK 001.

Social media use and patient ratings in shoulder and elbow surgeons: how many "likes" for five stars?

BACKGROUND: Social media plays an important role in healthcare and physician selection by facilitating direct communication with patients and impacting physician ratings. A concern however is the increased online scrutiny and negative impact on patient satisfaction with these connections. This study aimed to investigate whether social media activity by fellowship-trained shoulder and elbow surgeons impacts patient's perceptions and ratings on physician review websites (PRWs). METHODS: The American Shoulder and Elbow Surgeons physician directory was used to identify currently practicing shoulder and elbow surgeons in the United States. Physician ratings were collected from Healthgrades, Google reviews, and Vitals. The surgeons were divided into two groups: social media users (SMU) and non- SMU (NSMU). The association of social media use with online physician ratings was evaluated using simple and multilinear regressions. RESULTS: A total of 385 American Shoulder and Elbow Surgeons surgeons were included and 21.3% were SMU. SMU were younger (mean age, 48 years) compared to NSMU (mean age, 51 years) (P = .01), all other demographics were comparable including sex (P = .797), medical degree (P = .114), and geographic location within the United States (P = .49). SMU had significantly higher ratings on Healthgrades (P < .001) and Vitals (P < .001). However, social media use did not impact the total number of ratings on PRWs. Additionally, surgeons who utilized Facebook had higher physician ratings and number of website reviews on Healthgrades (P = .028 and P = .014, respectively). In addition, surgeons who used Twitter had higher ratings on Healthgrades (P < .001) and Vitals (P = .001). Surgeons with a greater average number of likes per post on Twitter had significantly higher average ratings across all three sites (P = .004). Surgeons with a greater number of Twitter followers and greater average number of likes per post had significantly higher average ratings on Healthgrades (P = .052 and P = .005, respectively) while surgeons with a greater average number of likes per post had significantly higher average ratings on Vitals (P = .006). Finally, surgeons with a greater average posting frequency on Instagram had significantly higher average ratings across all websites (P = .029). CONCLUSION: Shoulder and elbow surgeons who use Twitter and Facebook had significantly higher online ratings. However, the increased use of these platforms in terms of postcontent, postfrequency, comments, and number of followers was not as influential on PRWs. This suggests that social media is an important marketing and outreach method for orthopedic surgeons to improve their ratings and patient reviews.