Toward spreadable entertainment-education: leveraging social influence in online networks.

Entertainment-education (EE) is a communication strategy that uses popular media to engage with audiences on prosocial topics such as health, social tolerance and sustainability. The purpose of EE serials on radio, television or the internet is to introduce new ideas, norms and practices by means of storytelling, as well as to offer points of engagement for audiences to talk about the themes raised by the intervention. However, in today's media landscape, it has become increasingly difficult to captivate audiences as they have fragmented across channels and have started to create and circulate content themselves. The concept of spreadable media allows us to deal with fragmentation and user-generated content in productive ways, as it recognizes the role of autonomous audience members in shaping the flows of media content in the online networks that underlie today's media landscape. In this article, we introduce spreadable EE: an innovative approach that builds on transmedia storytelling strategies to reach and captivate target audiences for a longer period of time, and that entails collaboration with online platforms, communities and social influencers to stimulate meaningful conversations. We enhance EE's theoretical, empirical and practical traditions with insights about how today's audiences have come to engage with media and propose strategic approaches to create and evaluate spreadable EE.

Health Information Related to Cardiovascular Diseases Broadcast on Chinese Television Health Programs.

This study aims to add to the knowledge about information depicted in television health programs in China. Cardiovascular diseases (CVDs) are the leading cause of death in the country. The threat it poses is particularly notable among the Hui ethnic minority people, who have a higher prevalence of cardiovascular risk factors. Little research has been conducted thus far on content concerning CVDs in Chinese television health programs, and this study aims to fill this lacuna. Qualitative content analysis was conducted to analyze The Doctor Is In and Health Body Light. The results revealed that these two programs presented information about what CVDs and CVRFs are, how the former are treated, and what strategies are used to communicate health information. A new topic also stood out: discussions on how traditional Chinese medicine prevents and cures these diseases.

A Qualitative Content Analysis of Cardiovascular Diseases Related Health Information Targeted at the Hui Minority on Chinese WeChat Official Accounts.

In this study, we focus on the information available in WeChat official accounts about cardiovascular diseases (CVDs), which are a leading cause of death in China. We are particularly interested in information targeting the Chinese Hui minority people, who have a high prevalence of cardiovascular risk factors (CVRFs). Our exploratory research therefore investigates whether and how the articles on WeChat official accounts are targeted at the Hui people. We used a qualitative approach to analyze 108 articles. Two related themes emerged: descriptions of how to live a healthy life; and explanations of CVDs and CVRFs. Traditional Chinese medicine likewise surfaced from the analysis as a specific and unique theme in the Chinese social and cultural context. Despite the high prevalence of CVRFs among the Hui, none of the articles included information tailored to them.

Validation of the Multicultural Personality Questionnaire Short Form (MPQ-SF) for use in the context of international education.

The Multicultural Personality Questionnaire (MPQ) is one of the most widely used instruments for measuring individuals' intercultural competences. The original version consists of 91 items, divided into five subscales, and has been shown to predict attitudes, behavior, and outcomes in a variety of intercultural contexts. Recently, a 40-item short form of the MPQ was developed (MPQ-SF), which may be particularly useful in settings in which time or survey space are limited, or where respondent drop-out is likely to occur. For example, the MPQ-SF would be a valuable tool for assessing longitudinal development of multicultural personality traits in training or educational settings. A prerequisite for such research is to establish measurement invariance of the MPQ-SF between different respondent groups, as well as across time points. Using a sample of students in an international university program (n = 519), the present study examines how the scales perform among male and female respondents, between students of Western and Non-Western background, and across two time points, five months apart. Based on our findings, we conclude that all five subscales of the MPQ-SF display sufficient measurement invariance to be reliably used in this and similar contexts, in comparative as well as longitudinal study designs.

Understanding the Chinese Hui Ethnic Minority's Information Seeking on Cardiovascular Diseases: A Focus Group Study.

The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) than most other ethnic groups. Therefore, the availability of health information relating to these factors is especially important for the Hui minority's preventive healthcare. They do, however, experience difficulties in obtaining health-related information. The current research aims to identify the needs of the Hui people on where and how they obtain cardiovascular disease (CVD) related information from the media and other sources. Six focus groups were conducted in Shenyang City. The results revealed that the participants relied on different sources to get advice about CVDs, of which the internet and television were the most prominent ones. The participants expressed a desire for credible and professional information from different sources and asked for mediated health communication programs specifically targeted at the Hui. In addition, the participants felt ignored by the Chinese mainstream media at large, which created barriers for them to get health information.

Mapping the Dutch vaccination debate on Twitter: Identifying communities, narratives, and interactions.

In recent years, vaccination rates in the Netherlands have declined slightly, but steadily. The Dutch National Institute for Public Health and the Environment (RIVM) commissioned a Committee for Vaccine Willingness (VWC) to study the societal context of the decline. One of the societal contexts is the Internet, where audiences discuss vaccination and refer to sources of health-related information of varying quality. Working for the VWC, we have explored the Dutch vaccination debate on Twitter in order to: (1) identify online communities in the vaccination debate, (2) identify vaccine-related narratives; and (3) understand how the online communities interact with each other. We identified seven different communities, including (public) health professionals, writers and journalists, anti-establishment, and international vaccination advocates. The debate is spearheaded by the writers & journalists community, while the health- and anti-establishment communities try to influence it. The health community circulates facts, figures and scientific studies, while negative messages about vaccination - either from a homeopathy or conspiracy perspective - are most prevalent in the anti-establishment. The facts and figures shared by the health community hardly reach other communities, whereas the myths introduced by the anti-establishment do spill over to other communities. Our study provides further evidence that negative perceptions about vaccination might be rooted in a wider sentiment of distrust of traditional institutions. We argue that Dutch health organizations should try to address questions, doubts, and worries among the general audience more actively, and present scientific information in a simpler and more attractive way.

Tailoring in the digital era: Stimulating dialogues on health topics in collaboration with social media influencers.

In today's media landscape, audiences increasingly turn to online communities for media consumption and to exchange information about specific niche interests such as health-related topics. This calls for a segmented approach in which interventions are targeted at online communities, tailored to their specific cultures and health-related perceptions, and leverage the dynamics of conversation and social influence in online networks. Strategies drawn from the field of influencer marketing provide interesting opportunities to reach and engage with audiences in a personally relevant manner, including with those who may disagree with an intervention's message. This article reflects on what health communicators might learn from influencer strategies and proposes digital methods to target and tailor health communication in the digital era. More concretely, we present methods to: (a) identify online communities engaging on a specific health issue; (b) map community specific cultures and health-related perceptions; and (c) identify influencers as potential collaboration partners. As such, we adopt a slightly different take on tailoring by putting the creative and cultural competences of social influencers central, and by aligning our methods with a media mapping protocol to create influencer strategies that are tailored to the cultures and health-related perceptions of multiple online audience segments. We illustrate the potential of these methods with a study of how vaccination is discussed among Dutch Twitter users.

Urban Influencers: An Analysis of Urban Identity in YouTube Content of Local Social Media Influencers in a Super-Diverse City.

Influencers belong to the daily media diet of many adolescents. As role models, they have the potential to play a crucial role in the identity construction of their viewers. In the age of social media, such role models may now be found more locally - in the same city - and perhaps with more diverse backgrounds. This may be particularly valuable to adolescents growing up in super-diverse cities, as they are surrounded by a multitude of groups and identities during a life phase in which they have to make sense of who they are and where they belong. Despite the heterogeneity of these identities, there is one thing all have in common: the city they live in. With the city as a common framework, local influencers may be important role models for these adolescents, particularly in negotiating their urban identity. This paper aims toward mapping the ways in which social media can play a role in the negotiation of urban identity among youngsters by investigating how YouTube influencers from a super-diverse city are related to each other online, and how their content relates to the (super-diverse) city of Rotterdam. Findings show that in their videos and on their channel pages, influencers mainly affiliate themselves with the city through having the city as the background and context of the videos, through their involvement with cultural trends (e.g., soccer, hip-hop) that link to the city, and through their affiliation with other local influencers. We argue that influencers may therefore provide their viewers with content that may potentially help their local viewers strengthen their urban identity.

Chinese Urban Hui Muslims' Access to and Evaluation of Cardiovascular Diseases-Related Health Information from Different Sources.

This research aims to identify the sources that urban Hui Muslims access to get health information related to cardiovascular diseases (CVD) and how they evaluate the information from different sources. This paper focuses on health information related to cardiovascular diseases among Hui Muslims. The data was gathered by means of an online survey administered on mobile devices. To put the answers given by Hui Muslims into perspective and make a comparison between Hui Muslims and the Han people, we also gathered information from Han-the dominant group in China. The results showed that Chinese Hui Muslims mostly used mediated sources, while Han people mainly used interpersonal sources. Both Hui Muslims and Han people trusted and preferred health information about cardiovascular diseases provided by health organizations, doctors, and healthcare providers. The information given by religious leaders was trusted the least, although Hui Muslims were significantly more positive about religious authority than the Han people. The current results are relevant for Chinese health information promoters and can help them diffuse CVD health information more effectively to urban Hui Muslims.

A weak scientific basis for gaming disorder: Let us err on the side of caution.

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Appeal of playing online First Person Shooter Games.

First Person Shooter Games (FPSG) such as Counter Strike are often the subject of public concern. Surprisingly, there is no published research available about playing these games. We conducted an exploratory Internet survey (n 5 751) in order to gather information about who the players of online first person shooters are, and why they spend time on playing this particular kind of video game. The results of our survey on the one hand confirmed the stereotype of the gamer as it is often presented in popular media: the players of online FPS were indeed almost exclusively young men (mean age about 18 years) who spend a lot of their leisure time on gaming (about 2.6 h per day). We also found that the most committed gamers, that is, the ones who were members of a (semi)professional clan, scored highest on motives with respect to competition, and challenge in comparison with members of amateur clans and online gamers who had not joined a clan. On the other hand, our results cast doubt on the accuracy of the stereotype. This study showed clearly that online FPSG are not played in isolation. More than 80% of our respondents were member of a clan. Also, the regression analysis showed that the social interaction motive was the strongest predictor of the time actually spend on gaming.

Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal.

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.