Social media uses amongst adolescents: motives, minority stress and eudaimonic well-being / Uso de redes sociales en adolescentes: motivación, estrés de minorías y bienestar eudaimónico

Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In gen-eral, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives:This study ex-amines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M= 16.19; SD= 1.08), analysing the Scale of Motives for Using Social Net-working Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results:The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online;and that females have higher levels of well-being. Discus-sion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Dif-ferentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)

Introduction: The scientific evidence regarding the effects of online social media use on the well-being of adolescents is mixed. In general, passive uses (receiving, viewing content without interacting) and more screen time are related to lower well-being when compared with active uses (direct interactions and interpersonal exchanges). Objectives: This study examines the types and motives for social media usage amongst adolescents, differentiating them by gender identity and sexual orientation, as well as its effects on eudaimonic well-being and minority stress. Method: A cross-sectional study was conducted with 1259 adolescents, aged 14 to 19 (M = 16.19; SD = 1.08), analysing the Scale of Motives for Using Social Networking Sites, eudaimonic well-being, the Sexual Minority Adolescent Stress Inventory, screen time and profile type. Results: The results found that longer use time is related to finding partners, social connection and friendships; that gay and bisexual (GB) adolescents perceive more distal stressors online; and that females have higher levels of well-being. Discussion: The public profiles of GB males increase self-expression, although minority stress can be related to discrimination, rejection or exclusion. Differentiated socialization may contribute to a higher level of well-being in females, with both active and passive uses positively effecting eudaimonic well-being in adolescents.(AU)

Narcissism, perfectionism, and self-promoting behavior on social networking sites among university students in Pakistan / Narcisismo, perfeccionismo y comportamiento de autopromoción en sitios de redes sociales entre estudiantes universitarios en Pakistán

Existe un debate considerable en la literatura sobre cómo el narcisismo predice diversos comportamientos asociados con la utilidad de los sitios de redes sociales, pero los investigadores han prestado menos atención a explorar los mediadores potenciales de esta relación. Con base en la literatura existente, anticipamos que el narcisismo predice comportamientos de autopromoción en los sitios de redes sociales. El estudio actual también investigó el papel mediador del perfeccionismo multidimensional entre el narcisismo y el comportamiento de autopromoción. Se recopiló un total de 605 cuestionarios completos de estudiantes de universidades de Rawalpindi e Islamabad, Pakistán, mediante un muestreo conveniente. El estudio utilizó el Inventario de Personalidad Narcisista (Ames et al., 2006), un cuestionario de desarrollo propio sobre comportamiento de autopromoción en sitios de redes sociales y la Escala de Perfeccionismo Multidimensional (Hewitt et al., 1991). Los hallazgos indicaron que las mujeres en comparación con los hombres y las solteras en comparación con las casadas obtuvieron puntuaciones más altas en narcisismo. Los niveles educativos más altos se asociaron con tasas más altas de narcisismo. Los resultados también sugieren que el narcisismo se correlaciona con el perfeccionismo orientado a uno mismo y, más significativamente, con el narcisismo orientado a los demás. El perfeccionismo orientado a uno mismo y a los demás medió significativamente la relación entre el narcisismo y el comportamiento de autopromoción en los sitios de redes sociales.(AU)

There is considerable debate in the literature about how narcis-sism predicts various behaviors associated with the utility of social net-working sites, but researchers have paid less attention to exploring the po-tential mediators of this relationship.Based on the existing literature, we anticipated that narcissism predicts self-promoting behaviors on social networking sites. The current study also investigated the mediating role of multidimensional perfectionismbetween narcissism and self-promoting behavior. A total of 605 complete questionnaires weregathered fromstu-dents from universities from Rawalpindi and Islamabad, Pakistan using convenient sampling. The study used Narcissistic Personality Inventory (Ames et al., 2006), self-developed Self-promoting Behavior on social net-working sites questionnaire, and the Multidimensional Perfectionism Scale (Hewitt et al., 1991). Findings indicated that females as compared to males and single as comparedto married individuals scored higher on narcissism. Higher educational levels were associated with higher rates of narcissism. The results also suggestthat narcissism correlated with self-oriented per-fectionism, and more significantlywith others-oriented narcissism. Self-oriented and others-oriented perfectionism significantly mediated the rela-tionship between narcissism and self-promoting behavior on social net-working sites.(AU)

Helpful or Not? A Qualitative Study on Female Adolescents' Experience of TikTok When Recovering From Anorexia Nervosa.

OBJECTIVE: The scientific literature reports on how social media potentially influences eating disorders, although there is a large gap in the specific case of TikToks influence of adolescent's recovery from anorexia nervosa (AN). Our study uses in-depth interviews with female adolescents primarily suffering from AN to explore how they perceive the social media platform TikTok in relation to their recovery. METHOD: A total of 14 interviews with female adolescents recovering from AN were conducted and analyzed with reflexive thematic analysis. RESULTS: We developed four distinct main themes: social connectivity, algorithmic engagement, regulation and adaptation, and personal agency and recovery pathways. Our findings indicate both potential benefits and harm by TikTok use when in recovery from AN, depending on a complex interplay of individual and contextual factors. DISCUSSION: The study adds nuance to the on-going scientific debate on the role that TikTok plays in recovery from AN in general from the perspective provided by female adolescents. Suggestions are made for clinical implications at adolescent AN outpatient care including parental or professional support in TikTok adaptations and advice on how to discern when use may be triggering or supportive. Future research would benefit from longitudinal designs and inclusion of how individual differences, such as gender and personality, influence the effects on recovery and TikTok use.

Shaping and Designing Health Communication Messages Around Culture in the Kingdom of Saudi Arabia.

The Kingdom of Saudi Arabia launched several health campaigns tailored to the Saudis' culture over the past few years. These campaigns drew attention toward shifting to and maintaining healthy lifestyles and health-disorder management, particularly diabetes. Almost all the campaigns achieved success stories. These success stories were manifested by fruitful outcomes such as increasing vaccination rates and receiving awards (i.e., the "Marketing Pioneers Award"). This paper presents the development strategy and communicates the most recently culturally adapted health campaigns implemented by the Kingdom of Saudi Arabia Ministry of Health.

Identifying Medicine Shortages With the Twitter Social Network: Retrospective Observational Study.

BACKGROUND: Early identification is critical for mitigating the impact of medicine shortages on patients. The internet, specifically social media, is an emerging source of health data. OBJECTIVE: This study aimed to explore whether a routine analysis of data from the Twitter social network can detect signals of a medicine shortage and serve as an early warning system and, if so, for which medicines or patient groups. METHODS: Medicine shortages between January 31 and December 1, 2019, were collected from the Dutch pharmacists' society's national catalog Royal Dutch Pharmacists Association (KNMP) Farmanco. Posts on these shortages were collected by searching for the name, the active pharmaceutical ingredient, or the first word of the brand name of the medicines in shortage. Posts were then selected based on relevant keywords that potentially indicated a shortage and the percentage of shortages with at least 1 post was calculated. The first posts per shortage were analyzed for their timing (median number of days, including the IQR) versus the national catalog, also stratified by disease and medicine characteristics. The content of the first post per shortage was analyzed descriptively for its reporting stakeholder and the nature of the post. RESULTS: Of the 341 medicine shortages, 102 (29.9%) were mentioned on Twitter. Of these 102 shortages, 18 (5.3% of the total) were mentioned prior to or simultaneous to publication by KNMP Farmanco. Only 4 (1.2%) of these were mentioned on Twitter more than 14 days before. On average, posts were published with a median delay of 37 (IQR 7-81) days to publication by KNMP Farmanco. Shortages mentioned on Twitter affected a greater number of patients and lasted longer than those that were not mentioned. We could not conclusively relate either the presence or absence on Twitter to a disease area or route of administration of the medicine in shortage. The first posts on the 102 shortages were mainly published by patients (n=51, 50.0%) and health care professionals (n=46, 45.1%). We identified 8 categories of nature of content. Sharing personal experience (n=44, 43.1%) was the most common category. CONCLUSIONS: The Twitter social network is not a suitable early warning system for medicine shortages. Twitter primarily echoes already-known information rather than spreads new information. However, Twitter or potentially any other social media platform provides the opportunity for future qualitative research in the increasingly important field of medicine shortages that investigates how a larger population of patients is affected by shortages.

Rates and psychological stress predictors of problematic internet use (PIU) during the COVID-19 pandemic in a racially diverse sample of young adults.

BACKGROUND: Problematic internet use (PIU), which includes social media misuse (SMM) and gaming misuse (GM), is uncontrollable and associated with significant psychological impairment. PIU is a coping behavior for COVID-19-related stress. We explored distress-related predictors of PIU in a young adult racially diverse sample during the pandemic. METHODS: Analyses used cross-sectional survey data (N = 1956). Psychological diagnoses, financial distress, COVID-19-related emotions, psychological distress, distress tolerance, social support, loneliness, SMM and GM were measured. Hierarchical multiple regressions identified predictors of PIU. Race-stratified exploratory analyses sought to understand if predictors held true across racial groups. RESULTS: Low distress tolerance was associated with SMM and GM, as were depression symptoms, with racial differences observed. SMM was associated with younger age, and GM was associated with male gender. PTSD symptoms predicted more GM. SMM and GM rates varied between racial groups. COVID-19-related adjustment challenges and stress predicted SMM and GM respectively, with racial differences observed. CONCLUSION: Individual psychological distress and low distress tolerance markedly increased PIU risk. Clinicians should screen for stress-related PIU risk factors and bolster distress tolerance in vulnerable patients. Comparing PIU to different forms of coping in a larger sample would further clarify groups differences in stress coping behaviors.

Orthodontic YouTube™ videos made by patients for patients: What are they about and are they accurate?

OBJECTIVES: To evaluate the characteristics and content of YouTube™ videos created by patients undergoing orthodontic fixed appliance treatment and to assess the content accuracy of these videos. DESIGN: A mixed-methods quantitative and qualitative study. DATA SOURCE: YouTube™ webpage. METHODS: The term 'braces' was used to search for relevant videos on the YouTube™ webpage between 18 August and 30 August 2020, with no limits imposed regarding how long the video had been available on YouTube™. Videos were included if they were made by patients and were predominantly about patients' experiences during treatment with labial fixed appliances. The main themes/subthemes of the included videos were identified. A checklist was then developed to assess accuracy of the video content for two of the main themes and the videos were assessed against the checklist. RESULTS: The video search identified 350 videos, of which 64 were selected as potentially eligible; 41 were subsequently excluded as they related primarily to the bond up/debond experience or had minimal information about orthodontics. This meant that 23 videos were ultimately included for analysis. Six main themes were identified in the videos: problems with fixed appliances, effects of fixed appliances, oral hygiene maintenance, dietary advice, treatment duration/appointment frequency and auxiliaries used with fixed appliances. From the 23 videos, 20 were assessed against the checklist for content accuracy related to two selected themes: oral hygiene maintenance and dietary advice. The majority of videos had low content accuracy scores, indicating that important and relevant content was generally missing. CONCLUSION: Several included videos focused on oral hygiene maintenance and dietary advice associated with fixed appliances; however, the content was incomplete and not always accurate. This is concerning to the profession, and it is therefore recommended that clinicians consider collaborating with patients to produce videos that are patient-centred and that also contain accurate information.

Positive and negative factors of the influence of new media and the digital environment on ideal and belief education among university students in China.

The authors identity the relationship between the positive and negative aspects of social media and the ideal belief learning and behavior of university students. The cluster sampling method was adopted in the paper, including Guangdong, Shandong, Henan, Sichuan, and Jiangsu provinces. A total of 1014 questionnaires were distributed to a purposive sample of university students between the ages of 16 and 35. The authors applied the uses and gratifications theory to study students' social media behavior. This study identified 18 positive and negative effects of social media. Noteworthy positive outcomes attributed to social media in fostering ideals and beliefs encompass heightened awareness, enhanced communication facilitation, convenient connectivity, reduced expenses on educational materials, improved social and communication proficiencies, as well as diminished stress levels. The negative effects of new media and the Internet include a lack of critical thinking, a waste of time, dysgraphia, disrupted connection to learning, students' laziness, and health risks.

Exploring the Relationship Between Instagram Use and Self-Criticism, Self-Compassion, and Body Dissatisfaction in the Spanish Population: Observational Study.

BACKGROUND: The widespread use of online social networks, particularly among the younger demographic, has catalyzed a growing interest in exploring their influence on users' psychological well-being. Instagram (Meta), a visually oriented platform, has garnered significant attention. Prior research has consistently indicated that Instagram usage correlates with heightened levels of perfectionism, body dissatisfaction, and diminished self-esteem. Perfectionism is closely linked to self-criticism, which entails an intense self-scrutiny and is often associated with various psychopathologies. Conversely, self-compassion has been linked to reduced levels of perfectionism and stress, while fostering greater positive affect and overall life satisfaction. OBJECTIVE: This study investigates the relationship between Instagram usage (time of use and content exposure) and users' levels of self-compassion, self-criticism, and body dissatisfaction. METHODS: This study comprised 1051 adult participants aged between 18 and 50 years, either native to Spain or residing in the country for at least a decade. Each participant completed a tailored questionnaire on Instagram usage, along with abbreviated versions of the Self-Compassion Scale, the Body Shape Questionnaire, and the Depressive Experiences Questionnaire, spanning from January 23 to February 25, 2022. RESULTS: A positive correlation was observed between daily Instagram usage and self-criticism scores. Participants of all age groups who spent over 3 hours per day on Instagram exhibited higher self-criticism scores than users who spent less than 1 hour or between 1 and 3 hours per day. Contrary to previous findings, no significant relationship was detected between Instagram usage time and levels of self-compassion or body dissatisfaction. Furthermore, content centered around physical appearance exhibited a positive correlation with self-criticism and body dissatisfaction scores. Among younger participants (aged 18-35 years), those who primarily viewed beauty or fashion content reported higher self-criticism scores than those consuming science-related content. However, this association was not significant for participants aged 35-50 years. Conversely, individuals who predominantly engaged with sports or fitness or family or friends content exhibited higher levels of body dissatisfaction than those focusing on science-related content. No significant associations were observed between self-compassion scores and daily Instagram usage or most-viewed content categories. CONCLUSIONS: The findings of this study underscore the considerable impact of Instagram usage on self-criticism and body dissatisfaction-2 variables known to influence users' psychological well-being and be associated with various symptoms and psychological disorders.

Attentional bias to social media stimuli is moderated by fear of missing out among problematic social media users.

Background and aims: Previous evidence has indicated that problematic social media use (PSMU) is characterized by an attentional bias to social media icons (such as Facebook icons), but not to social webpages (such as Facebook webpages). They suggest that there may be other factors influencing attentional bias like fear of missing out (FoMO). But it remains unclear how FoMO moderates attentional bias in PSMU. This study aims to investigate whether PSMU show attentional bias for stimuli associated with social media, and how FoMO moderates on attentional bias among PSMU through experimental methods. Methods: Based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, this study explored mechanisms of attentional bias to social media icons (such as WeChat) related to PSMU and further examined the role of FoMO in this relationship. Specifically, attentional bias patterns to social media icons of 62 participants (31 PSMU and 31 control group) were explored during a dot-probe paradigm combined with eye-tracking in Experiment 1, and attentional bias patterns to social media icons of another 61 individuals with PSMU with different FoMO levels was explored during a dot-probe paradigm combined with eye-tracking in Experiment 2. Results: Results revealed that individuals with PSMU had an attentional bias toward social media icons, demonstrated by attentional maintenance, and such bias such bias was moderated by FoMO negatively, demonstrated by attentional vigilance and maintenance in PSMU/high FoMO. Conclusion: These results suggest that attentional bias is a common mechanism associated with PSMU, and FoMO is a key factor on the development of PSMU.

Differentiating the associations of passive and active social media use with e-cigarette use among U.S. youth.

PURPOSE: The impacts of passive (i.e., browsing) versus active (i.e., engagement) use of social media on e-cigarette use among youth have been understudied in existing literature. This study examines how passive and active use of social media are differentially associated with e-cigarette use among youth and how risk perceptions mediate these associations. METHODS: Pooled data from the 2021 and 2022 National Youth Tobacco Survey (N=48,704, aged 11-19) were used. Weighted structural equation models were employed to estimate the associations between passive and active social media use and youth e-cigarette use. RESULTS: Both passive and active social media use were associated with higher odds and more days of e-cigarette use among youth. E-cigarette risk perceptions mediated the associations between active use and both the likelihood of ever using e-cigarettes and the number of days of use. Risk perceptions mediated the association between active, but not passive, use and the number of days of e-cigarette use. Compared to passive use, active use was overall associated with higher odds and more days of youth e-cigarette use. DISCUSSION: The findings suggest that public health efforts should distinguish between passive and active social media use when designing and executing interventions. Attention and efforts should also be directed towards understanding the distinct indirect effects of passive and active social media use through risk perceptions. These findings advance our theoretical understanding of the role of different types of social media use and offer significant practical insights for interventions.

Better than average Bopo: Identifying which body positive social media content is most helpful for body image among women.

Body positive social media content, and especially content that does not contain photos of bodies, has been shown to be helpful for body image compared to idealized social media content. However, body positive content is heterogenous and little is known regarding which types of content may be most helpful. This study examined self-reported body image and mood effects of different types of body positive content among women. A sample of 176 women, mean (SD) age = 21.77 (2.35) was recruited. Participants viewed body positive stimuli that were grouped into 14 different categories to represent the heterogenous nature of this social media content, including a text only category. Each image was rated in terms of its perceived effect on body image and mood. Findings suggested that the text-only category was rated most highly in terms of generating positive feelings towards the body and positive affect. Moreover, the comparative benefit of the text-only category was larger among women with higher BMI, and participants reporting closer proximity to the images, although not consistently across outcomes. Further work focused on understanding the effects of different types of body positive content is warranted.

Assessing Patient Satisfaction Following Facelifts with Social Media Reviews.

BACKGROUND: Facelifts are one of the most common facial aesthetic surgery procedures. Patient satisfaction determines success of most aesthetic surgery but has been historically difficult to assess. OBJECTIVE: This study evaluated reviews by facelift patients on the aesthetic surgery social media website RealSelf.com to determine positive and negative factors underlying patient satisfaction following facelifts. METHODS: Facelift reviews were gathered from RealSelf.com with an automated web crawler. Reviews were categorized as positive or negative and by the primary and secondary reasons for the positive or negative review. Patient "worth it" and star ratings, physician specialty, and cost of procedure were also collected. RESULTS: A total of 2153 facelift reviews were collected. Overall, 1986 (92.24%) were positive and 167 (7.76%) were negative. The most common overall reasons for a positive review were aesthetic results (n=1571, 79.10%) and bedside manner (n=1488, 74.92%). The most common overall reasons for a negative review were outcome (n=137, 82.04%) and bedside manner (n=82, 49.10%). Most facelifts were performed by plastic surgeons (n=1796, 83.42%). The greatest 5-star rating percentages were seen for oral and maxillofacial surgeons (n=29, 93.55%), otolaryngologists (n=96, 92.31%), and plastic surgeons (n=1642, 91.43%). Of patients who provided a "worth it" rating, 1216 (91.91%) stated that their facelift was "worth it." CONCLUSION: Overall patient sentiment toward facelifts was positive. The factors most commonly affecting a positive patient experience were bedside manner and aesthetic results. Negative patient reviews were primarily attributed to dissatisfaction with aesthetic outcomes. Social media serves as a valuable tool for evaluating patient satisfaction with aesthetic surgery. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Developing Causality and Severity Assessment Frameworks for Food Safety Signals Using Social Media Reviews: A Technical Report Based on Data From an Urban Indian Suburb.

Social media reviews are a valuable data source, reflecting consumer experiences and interactions with businesses. This study leverages such data to develop a passive surveillance framework for food safety in urban India. By employing a Bidirectional Encoder Representations from Transformers (BERT)-powered Aspect-Based Sentiment Analysis tool, branded as Eat At Right Place (ERP), the study analyses over 100,000 reviews from 93 restaurants to identify and assess food safety signals. The Causality Assessment Index (CAI) and Severity Assessment Score (SAS) are introduced to systematically evaluate potential risks. The CAI uses pattern recognition and temporal relationships to establish causality while the SAS quantifies severity based on sub-aspects such as cleanliness, food handling, and unintended health outcomes. Results indicate that 40% of the restaurants had a CAI above 1, highlighting significant food safety concerns. The framework successfully prioritizes corrective actions by grading the severity of issues, demonstrating its potential for real-time food safety management. This study underscores the importance of integrating innovative data-driven approaches into public health monitoring systems and suggests future improvements in natural language processing algorithms and data source expansion. The findings pave the way for enhanced food safety surveillance and timely regulatory interventions.

Influence of Breast Cancer Awareness Month on Public Interest of Breast Cancer in High-Income Countries Between 2012 and 2022: Google Trends Analysis.

BACKGROUND: Breast cancer is the most common cancer among women worldwide. High-income countries have a greater incidence and mortality rate of breast cancer than low-income countries. As a result, raising awareness about breast cancer is crucial in increasing the chances of early detection and treatment. Social media has evolved into an essential tool for Breast Cancer Awareness Month campaigns, allowing people to share their breast cancer stories and experiences while also providing a venue for education and support. OBJECTIVE: The aim of this study was to assess the level of public interest in searches linked to breast cancer among a sample of high-income nations with a sizable internet user base from 2012 to 2022. We also sought to compare the proportional search volume for breast cancer during Breast Cancer Awareness Month with that during other months of the year. METHODS: Google Trends was used to retrieve data on internet user search behaviors in the context of breast cancer from 2012 to 2022. Seven countries were evaluated in this study: Australia, Canada, Ireland, New Zealand, the United Kingdom, Saudi Arabia, and the United States, in addition to global data. Breast cancer relative search volume trends were analyzed annually, monthly, and weekly from 2012 to 2022. The annual percent change (APC) was calculated for each country and worldwide. Monthly and weekly data were used to identify potential trends. RESULTS: A fluctuating pattern in APC rates was observed, with a notable increase in 2018 and a significant decrease in 2020, particularly in Saudi Arabia. Monthly analysis revealed a consistent peak in search volume during October (Breast Cancer Awareness Month) each year. Weekly trends over a 20-year period indicated significant decreases in Australia, Canada, New Zealand, and the United States, while increases were noted in Ireland. Heatmap analysis further highlighted a consistent elevation in median search volume during October across all countries. CONCLUSIONS: These findings underscore the impact of Breast Cancer Awareness Month and suggest potential influences of governmental COVID-19 pandemic control measures in 2020 on internet search behavior.

Negative Sentiments Toward Anterior Cruciate Ligament Injury Prevention Outweigh Positive Awareness Discussions on Social Media.

OBJECTIVES: The aim of this study is to understand the current public discussion surrounding anterior cruciate ligament (ACL) injury prevention on social media and determine factors that influence levels of public engagement. METHODS: We performed a qualitative and quantitative cross-sectional analysis of ACL injury prevention techniques discussed on social media via the Twitter application programming interface (API). The Twitter API was queried from inception to May 2023 using keywords related to ACL injury and prevention. We conducted a thematic analysis of the posts and performed a sentiment analysis using natural language processing. A multivariable regression model was used to identify metadata that predicted higher engagement (media, links, tagging, hashtags). RESULTS: A subset of 1823 unique posts were analyzed from 1701 unique accounts. Most posts were raising awareness about ACL injury prevention (n=733, 40.2%), followed by opinions on the topic (n=390, 21.4%), specific prevention techniques (n=289, 15.9%), personal experiences (n=272, 14.9%), and research (n=139, 7.6%). The majority consisted of posts from patients or caregivers (n=948, 55.7%), whereas healthcare providers accounted for 14.7% of posts. Posts containing media increased Tweet engagement count by an average of 6.1 (95% CI 2.8 to 9.4, p=0.00033) and posts discussing personal opinions increased engagement by 6.7 (95% CI 3.5 to 9.8, p=0.00004). On sentiment analysis of all included Tweets, 822 (45.1%) posts were positive, 309 (17.0%) were negative, and 692 (38.0%) were neutral. Sentiments expressed in posts related to ACL prevention were 2.8 times more negative compared to those discussing raising awareness. CONCLUSIONS: There is active discussion about ACL injury prevention on Twitter. The use of visual media increased public engagement. We identified a potential knowledge gap between the available prevention techniques and the perspectives of athletes, highlighting the need for healthcare professionals to enhance their engagement with ACL injury prevention on social media. LEVEL OF EVIDENCE: III.

Equity-informed social media COVID-19 risk communication strategies: a scoping review.

OBJECTIVES: The COVID-19 pandemic has had devastating worldwide impact but most prominent was its effect on marginalised, underserved and equity-deserving populations. Social media arose as an important platform from which health organisations could rapidly disseminate information to equity-deserving populations about COVID-19 risks and events, provide instructions on how to mitigate those risks, motivate compliance with health directives, address false information, provide the opportunity for engagement and immediate feedback. The objective of this scoping review was to synthesise the academic and grey literature on equity-informed social media risk communication strategies developed during the pandemic. DESIGN: The review followed the Arksey and O'Malley framework and focused on the research question: What are the promising principles, processes, and practices for producing equity-informed social media risk communications? DATA SOURCES: CINAHL Complete, MEDLINE (OVID), Business Source Complete, EMBASE database OVID, Scopus and PubMed's curated COVID-19 literature hub: LitCovid, PsycINFO OVID were searched using terms related to access to health services, social media, risk communication, misinformation, community engagement, infectious disease, pandemics and marginalisation, supplemented by grey literature from relevant health organisations. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies were eligible if the population of interest was an equity-deserving population, the concept discussed was COVID-19 risk communication and the article was published in English between January 2019 and December 2022. DATA EXTRACTION AND SYNTHESIS: COVIDENCE facilitated screening and extraction. Charted data were thematically analysed following Braun and Clarke's phased process. Preliminary findings were collaboratively discussed with representatives from health agencies and community organisations focused on serving equity-deserving groups. RESULTS: 12 studies were included. In terms of principles and process, studies emphasised the need to collaboratively create plans for message construction and targeted dissemination using a risk communication framework, capitalise on access to community resources and pre-established communication mediums and be considerate of population-specific needs and concerns. Practice entails careful consideration of communication mediums, language usage, communication frequency and evaluation. CONCLUSION: This scoping review provides valuable insights for health agencies and community organisations in developing principles, processes and practices to equitably communicate risk information through social media. Engagement with stakeholders further refined and confirmed the findings, offering insights for future crisis communication strategies.

Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9-17 years in China: a cross-sectional study.

BACKGROUND: Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. METHODS: From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9-17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. RESULTS: Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02-1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. CONCLUSIONS: These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.

Identifying children's environmental health risks, needs, misconceptions, and opportunities for research translation using social media.

As part of the Advancing Science, Practice, Programming, and Policy in Research Translation for Children's Environmental Health (ASP3IRE) center, machine learning, geographic information systems (GIS), and natural language processing to analyze more than 650 million posts related to children's environmental health are being used. Using preliminary analyses as examples, this commentary discusses the potential opportunities, benefits, challenges, and limitations of children's health social media analytics. Social media contains large volumes of contextually rich data that describe children's health risks and needs, characteristics of homes and childcare locations important to environmental exposures, and parent and childcare provider perceptions, awareness of, and misconceptions about children's environmental health. Twenty five million unique conversations mentioning children, with likes, views, and replies from more than 33 million X (formerly Twitter) users were identified. Many of these posts can be linked to traditional environmental and health data. However, social media analytics have several challenges and limitations. Challenges include a need for interdisciplinary collaborations, selectivity and sensitivity of analytical methods, the dynamic, evolving communication methods and platform preferences of social media users, and operational policies. Limitations include data availability, generalizability, and self-report bias. Social media analytics has significant potential to contribute to children's environmental health research and translation.

#CPR challenge: Impact of a social media campaign on cardiopulmonary resuscitation awareness and skills among young adults - A quasi experimental study.

Aim: The aim of our study was to explore the effect of nomination-based social-media campaign and CPR-skill-booth on change in knowledge as well as hands-only CPR skills among young adults. Methods: A quasi-experimental study was conducted in two non-healthcare-stream colleges, one intervention and other control arm. After baseline evaluation of CPR knowledge in both colleges, a 4-week nomination-based social media campaign '#CPR challenge' was rolled out in the intervention arm which included a CPR-skill-booth that was setup for one hour every day to train interested participants in CPR. The participants were encouraged to share the same on their social media handles and data of self-reported metrics were collected. A post-intervention assessment was conducted in both arms, to assess knowledge and its translation to hands-only-CPR skills using qCPR mannequin and qCPR app® for objective assessment. Results: A total of 690 assessments were done; Intervention arm (pre-intervention-214, post intervention -155) and control arm (pre-intervention -157, post-intervention -134). The baseline knowledge scores were comparable in both groups. Knowledge score doubled in the intervention arm, (p < 0.001) from a median value of 29% (IQR:14 - 43) in the pre-intervention-cohort to 57% (IQR:29 - 71) in the post-intervention-cohort. Median CPR-skill-score was higher in the intervention arm 67.5(IQR:39-92) in comparison to control arm 21 (IQR:1-53) (p < 0.001). In terms of social media engagement, 50% of participants had watched the videos and 40.6% attended the CPR-skill-booth. Conclusion: Strategies such as a nomination-based social media campaign can improve the awareness, knowledge and also skills regarding hand-only CPR.