Social Media, Public Health, and Community Mitigation of COVID-19: Challenges, Risks, and Benefits.

Shortly after the first case reports in 2019, COVID-19 was declared a pandemic. Early messages from trusted experts, which later proved to be inadequate or incorrect, highlight the need for continual adjustment of messages to the public as scientific knowledge evolves. During this time, social media exploded with greatly sought-after information, some of which was misinformation based on incomplete or incorrect facts or disinformation purposefully spread to advance a specific agenda. Because of the nature of social media, information, whether accurate or not at the time posted, lives on and remains accessible to the public even when its usefulness has been discredited. While the impact of mis/disinformation on COVID-19 risk-reducing behaviors is debatable, it is clear that social media has played a significant role in both extending the reach of COVID-19-related falsehoods and promoting evidence-based content. Over the last decade, social media has become a dominant source of information that consumers turn to for health information. A great deal of misinformation and disinformation has reached large numbers of social media users, which points to a need for the agencies of the US Public Health Service to create communications to convey accurate and current information and appeals that will actually be viewed. This viewpoint highlights the challenges, risks, and potential benefits that social media present in mitigating the COVID-19 pandemic.

Discussion of Weight Loss Surgery in Instagram Posts: Successive Sampling Study.

BACKGROUND: The majority of American adults search for health and illness information on the internet. However, the quality and accuracy of this information are notoriously variable. With the advent of social media, US individuals have increasingly shared their own health and illness experiences, including those related to bariatric surgery, on social media platforms. Previous research has found that peer-to-peer requesting and giving of advice related to bariatric surgery on social media is common, that such advice is often presented in stark terms, and that the advice may not reflect patient standards of care. These previous investigations have helped to map bariatric surgery content on Facebook and YouTube. OBJECTIVE: This objective of this study was to document and compare weight loss surgery (WLS)-related content on Instagram in the months leading up to the COVID-19 pandemic and 1 year later. METHODS: We analyzed a total of 300 Instagram posts (50 posts per week for 3 consecutive weeks in late February and early March in both 2020 and 2021) uploaded using the hashtag #wls. Descriptive statistics were reported, and independent 1-tailed chi-square tests were used to determine if a post's publication year statistically affected its inclusion of a particular type of content. RESULTS: Overall, advice giving and personal responsibility for outcomes were emphasized by WLS posters on Instagram. However, social support was less emphasized. The safety, challenges, and risks associated with WLS were rarely discussed. The majority of posts did not contain references to facts from reputable medical sources. Posts published in 2021 were more likely to mention stress/hardships of living with WLS (45/150, 30%, vs 29/150, 19.3%; P=.03); however, those published in 2020 more often identified the importance of ongoing support for WLS success (35/150, 23.3%, vs 16/150, 10.7%; P=.004). CONCLUSIONS: Given that bariatric patients have low rates of postoperative follow-up, yet post-operative care and yet support are associated with improved health and weight loss outcomes, and given that health content on the web is of mixed accuracy, bariatric professionals may wish to consider including an online support forum moderated by a professional as a routine part of postoperative care. Doing so may not only improve follow-up rates but may offer providers the opportunity to counter inaccuracies encountered on social media.

How did individuals on Instagram discuss COVID-19 in the month following official pandemic status? A examination of user content.

OBJECTIVES: Instagram is a popular social media site used by high numbers of young people. This study was designed to investigate COVID-19 content on Instagram during the month following official pandemic status from the World Health Organization (WHO). METHODS: A total of 200 posts were collected and analyzed over a four-week period between mid-February and mid-March 2020. RESULTS: The vast majority of posts did not address recommended prevention measures. Further, only approximately one-third of the posts referenced a reputable source. Finally, the nature of posts changed over time was impacted by type of poster and reflected a tone of anxiety. CONCLUSIONS: The findings underscore the urgent need for public health officials to be aware of and address social media content on novel health threats. Furthermore, it is imperative that communicating risk on social media, such as Instagram be geared to young people. Failure to do so may hinder prevention, mitigation, and suppression strategies.

YouTube Videos and Informed Decision-Making About COVID-19 Vaccination: Successive Sampling Study.

BACKGROUND: Social media platforms such as YouTube are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination. OBJECTIVE: The purpose of this study was to improve the understanding about the sources and content of widely viewed YouTube videos on COVID-19 vaccination. METHODS: Using the keywords "coronavirus vaccination," we searched for relevant YouTube videos, sorted them by view count, and selected two successive samples (with replacement) of the 100 most widely viewed videos in July and December 2020, respectively. Content related to COVID-19 vaccines were coded by two observers, and inter-rater reliability was demonstrated. RESULTS: The videos observed in this study were viewed over 55 million times cumulatively. The number of videos that addressed fear increased from 6 in July to 20 in December 2020, and the cumulative views correspondingly increased from 2.6% (1,449,915 views) to 16.6% (9,553,368 views). There was also a large increase in the number of videos and cumulative views with respect to concerns about vaccine effectiveness, from 6 videos with approximately 6 million views in July to 25 videos with over 12 million views in December 2020. The number of videos and total cumulative views covering adverse reactions almost tripled, from 11 videos with approximately 6.5 million (11.7% of cumulative views) in July to 31 videos with almost 15.7 million views (27.2% of cumulative views) in December 2020. CONCLUSIONS: Our data show the potentially inaccurate and negative influence social media can have on population-wide vaccine uptake, which should be urgently addressed by agencies of the United States Public Health Service as well as its global counterparts.

Use of the Instagram Hashtags #winemom and #momjuice Among Mothers During the COVID-19 Pandemic: Descriptive, Cross-sectional Study.

BACKGROUND: The tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males. OBJECTIVE: The purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic. METHODS: Using two popular hashtags, #momjuice and #winemom, 50 Instagram posts on each were collected from the "top posts" tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol. RESULTS: Overall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (>50%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed t test demonstrated this difference to be statistically significant (P=.0499). CONCLUSIONS: The findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care.

Community mitigation of COVID-19: Health communications and varied community reactions.

This article introduces a themed issue focused on COVID-19 as it relates to community health. In the context of attempting to curb transmission, a great deal of focus has been placed on community mitigation efforts. These efforts have presented a variety of challenges. This themed issue aims to give an overview of two important aspects of community mitigation, namely, issues relating to COVID-19 related messaging and reactions of different communities to the COVID-19 pandemic. The manuscripts in this issue demonstrate a range of methodology and offer insight into areas of COVID-19 research that can inform community health. They also cover an extensive range of topics and contribute to the literature in terms of informing efforts related to constructing effective messaging and identifying areas of need. Both of these focal points have implications for prevention and intervention.

A Thematic Analysis of Pre-Exposure Prophylaxis (PrEP) YouTube Videos.

Pre-exposure prophylaxis (PrEP) is an encouraging approach to HIV prevention, yet there is a paucity of research aimed at understanding individual PrEP experiences. The current study aims to examine first-hand narratives of individuals detailing their PrEP experiences via the YouTube platform. We searched YouTube.com using the keywords, "pre-exposure prophylaxis" and "Truvada". Search results were limited to the 15 most-viewed videos. Informed by a thematic/content analysis approach, we conducted an iterative analysis of video transcripts. Narratives covered a wide range of topics including the reasons to start PrEP, interaction with providers, side effects, insurance coverage, and stigma. By and large, the videos encouraged those at risk for HIV to consider PrEP. Narratives were often characterized by emotional engagement. Given that YouTube videos are used to share individual PrEP experiences with a wider audience, our analysis may inform the development of strategies aimed at utilizing YouTube for increasing uptake of PrEP.

Correction: Preventive Behaviors Conveyed on YouTube to Mitigate Transmission of COVID-19: Cross-Sectional Study.

[This corrects the article DOI: 10.2196/18807.].

Preventive Behaviors Conveyed on YouTube to Mitigate Transmission of COVID-19: Cross-Sectional Study.

BACKGROUND: Accurate information and guidance about personal behaviors that can reduce exposure to severe acute respiratory syndrome coronavirus 2 are among the most important elements in mitigating the spread of coronavirus disease 2019 (COVID-19). With over 2 billion users, YouTube is a media channel that millions turn to when seeking information. OBJECTIVE: At the time of this study, there were no published studies investigating the content of YouTube videos related to COVID-19. This study aims to address this gap in the current knowledge. METHODS: The 100 most widely viewed YouTube videos uploaded throughout the month of January 2020 were reviewed and the content covered was described. Collectively, these videos were viewed over 125 million times. RESULTS: Fewer than one-third of the videos covered any of the seven key prevention behaviors listed on the US Centers for Disease Control and Prevention website. CONCLUSIONS: These results represent an important missed opportunity for disease prevention.

'No one is as invested in your continued good health as you should be:' an exploration of the post-surgical relationships between weight-loss surgery patients and their home bariatric clinics.

This article traces the post-surgical relationship between weight-loss surgery (WLS) patients and their home bariatric clinics. Following surgery, there is substantive drop off in patient attendance at both follow-up appointments and support groups. While barriers to follow-up are often discussed with the bariatric literature, patients themselves are typically defined as the problem. Based upon a thematic analysis of 217 blog posts and comments in two top patient-led online forums, I demonstrate that bariatric patients tell a more complex story about their post-surgical lives. I argue that WLS patients constitute a population with highly specialised medical needs that is caught between the requirements for living with surgically altered digestive systems and a lack of sufficient post-operative follow-up care from their home bariatric clinics. Although online forums provide spaces for patients to examine these post-operative social and clinical experiences in critical terms, seek information and get support, ultimately the conversations serve to underline the value of personal responsibility for post-operative outcomes-a framing that echoes that of the bariatric profession. This framing should be understood within a larger climate of weight-based stigma and discrimination as well as neoliberal healthism.

'A beautiful show of strength': weight loss and the fat activist self.

This article explores the disciplinary and productive effects of late 20th-century/early 21st-century discourse around the obesity epidemic. For my purposes, both the Fat Activist and Weight Loss Surgery patient may be seen as outcomes of this discursive proliferation. Based on a content analysis of two online accounts of weight loss by prominent fat activists, I examine the ways in which such public declarations can be seen as contemporary examples of Foucault's notion of the confession. Through debates in the 'fatosophere', such activists and their peers simultaneously take up and reject both biomedical and fat activists tenets in ways that are highly ambivalent. In the process, fat activism unsettles and resituates its borders and boundaries and the issue of weight loss becomes a discursive technique of knowledge/power for the understanding of and relating to the fat activist self.