Health discussion network characteristics among a sample of people with inflammatory bowel disease.

OBJECTIVES: This study examined the health discussion networks (HDNs) of people with inflammatory bowel disease (IBD). We sought to test if HDN characteristics were associated with IBD management self-efficacy outcomes. METHODS: We recruited a sample of adults with IBD (N = 112) in December 2020 to take an online survey. Participants listed up to five people (alters) who they discussed their health with, and we used those data to construct individual HDNs. Participants provided demographic information about alters, and characterized alter by relationship, closeness, and support provided. We used multivariable regression to examine associations of HDN characteristics with IBD symptoms, remission, and emotions management self-efficacy outcomes. RESULTS: Participants reported data for 412 alters (mean HDN size: 3.68). Alters were mostly friends (40%) or family members (36%); few were healthcare workers (6%). In multivariable analyses, HDN size was associated with remission and emotions management self-efficacy (ps < .05), and the amount of support offered by alters was associated with emotions management self-efficacy (p < .05). DISCUSSION: HDN size and alter support variables were associated with some IBD management self-efficacy outcomes among our study sample. These findings provide empirical evidence about HDNs among people with IBD and support the notion that disease management is a collective effort.

What Drives People Away from COVID-19 Information?: Uncovering the Influences of Personal Networks on Information Avoidance.

The pervasive of COVID-19 information has driven some to escape daily conversations or media coverage. A rich set of theoretical discussions and empirical studies help explain why individuals avoid health risk information, but few studies have explored social network antecedents to information avoidance. This study investigates how personal discussion networks about COVID-19 shape individuals' information avoidance behaviors. Using a nationally representative sample (N = 1,304), we examined the effects of network size, heterogeneity, ego-alter dissimilarity, and social norms. Our results suggest that the four network variables had varying effects on different forms of information avoidance. Notably, social norms significantly predicted individuals' information avoidance. The theoretical and methodological implications of our findings are discussed.

How Public Health Agencies Break through COVID-19 Conversations: A Strategic Network Approach to Public Engagement.

In times of public health emergencies, health agencies need to engage and communicate with the public in real-time to share updates and accurate information. This is especially the case for the COVID-19 pandemic where public engagement can potentially save lives and flatten the curve. This paper considers how the use of interactive features and strategic network positions of health agencies on social media influenced their public engagement outcomes. Specifically, we analyzed 203 U.S. public health agencies' Twitter activity and the public engagement they received by extracting data from a large-scale Twitter dataset collected from January 21st to May 31st, 2020. Results show that health agencies' network position in addition to their two-way communication strategy greatly influenced the level of public engagement with their COVID-19 related content on Twitter. Findings highlight the benefits of strategic social media communication of public health agencies resides not only in how agencies use social media but also in their formation of network position to amplify their visibility. As official sources of health and risk information, public health agencies should coordinate their social media communication efforts to strategically position themselves in advantageous network positions to augment public engagement outcomes.

Peer-to-peer connections: Perceptions of a social support app designed for young adults with cancer.

OBJECTIVE: Social support is a critical, yet frequently unmet, need among young adults (YAs) with cancer. YAs desire age-appropriate resources to connect with peers. Peer-to-peer mobile apps are promising interventions to provide social support. Peer-to-peer apps will be more effective if development incorporates users' input for whether app designs (look and function) afford meaningful connections. METHODS: We interviewed 22 YAs to assess perceptions of a peer-to-peer app at a YA cancer convention in April 2017. RESULTS: Participants were an average age of 29, mostly female (77%), white (73%), and well educated (68% with 4-year college degree or higher). Most participants expressed interested in using an app to connect with YAs, but preferences varied by prevalence or rarity of one's cancer diagnosis. YAs shared trade-offs for profile anonymity versus profiles with more personal information, requests for filter options to connect for varying support needs, and desires for tailored messaging and chat room features (eg, topic-specific and search capabilities). CONCLUSION: Findings demonstrate the promise of apps to fulfill YA cancer survivors' unmet peer support needs and provide guidance for app optimization. CLINICAL IMPLICATIONS: Peer-to-peer support apps should be designed so users can control their identity and customize features for meaningful connections.

MSM Behavior Disclosure Networks and HIV Testing: An Egocentric Network Analysis Among MSM in China.

Men who have sex with men (MSM) disclose same-sex behaviors with others, creating disclosure networks. This study examined the characteristics of disclosure networks that are associated with HIV testing among MSM in China through an online nationwide survey. Name-generator questions were used to ask each participant ("ego") to nominate up to five social network members ("alters") with whom he had disclosed same-sex behaviors. Among the 806 men, the average disclosure network size was 4.05. MSM who reported larger disclosure networks were more likely to have been tested for HIV (aOR 1.21, 95% CI 1.08-1.34). The most common disclosure network alters were friends (45.1%), followed by sex partners (18.7%) and healthcare professionals (2.5%). Men who disclosed to healthcare professionals were more likely to test for HIV compared to men who disclosed to family members (aOR 5.43, 95% CI 2.11-14.04). Our findings can inform disclosure network-based interventions to promote MSM HIV testing.

A Secondary Audience's Reactions to "The Real Cost" Advertisements: Results From a Study of U.S. Young Adult Smokers and Susceptible Nonsmokers.

INTRODUCTION: Exposure to "The Real Cost" campaign has prevented smoking initiation among its target audience (U.S. youth aged 12-17 years). This study examines reactions to "The Real Cost" advertisements among a potential secondary audience: U.S. young adults. METHODS: An online convenience sample of young adult (ages 18-29 years) smokers (n=225) and susceptible nonsmokers (n=339) participated in a within-subjects experiment in 2017. Participants viewed three TV ads from "The Real Cost" campaign and reported their past exposure to, conversations about, and reactions to the ads. In 2017, analyses examined message-level and person-level predictors of perceived message effectiveness using multilevel modeling. RESULTS: About half of smokers (47%) and susceptible nonsmokers (51%) had seen at least one of the three ads in the past 3 months. About one in four smokers (23%) and susceptible nonsmokers (24%) had at least one conversation about the ads in the past 3 months. Susceptible nonsmokers rated the ads higher on perceived message effectiveness than smokers (p<0.01), but lower on message relevance and negative affective reactions to the ads (both p<0.05). In both samples, ads that elicited higher negative affective reactions and message relevance, and lower message reactance (i.e., resistance) received higher perceived message effectiveness ratings (all p<0.05). CONCLUSIONS: "The Real Cost" ads have reached and generated conversations among a convenience sample of young adult smokers and susceptible nonsmokers. Increasing the perceived relevance and emotional reactions of campaigns may increase their impact. Future studies should examine reactions to "The Real Cost" campaign and effects on smoking behavior using nationally representative samples of young adults. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Fifth Anniversary Retrospective of "The Real Cost," the Food and Drug Administration's Historic Youth Smoking Prevention Media Campaign, which is sponsored by the U.S. Food and Drug Administration.

The Audacity of Engagement: Hearing Directly from Young Adults with Cancer on Their Attitudes and Perceptions of Cancer Survivorship and Cancer Survivorship Research.

BACKGROUND: Young adult (YA) cancer survivors have been historically under-represented in cancer survivorship research, which has contributed to more disparate health outcomes compared with young and older cancer survivors. Using qualitative methods, this study explored YAs' perceptions of cancer survivorship and identified YA-specific barriers and preferences for participation in cancer survivorship research. METHODS: Individual interviews and focus groups were conducted with YA cancer survivors (N = 19) attending a patient-focused oncology conference. Grounded theory methodology guided analyses by using an inductive data-driven approach to thematic content analysis. RESULTS: Participants averaged 33 years old (standard deviation [SD] = 5.5), were 10 years postdiagnosis (SD = 2.3), and were primarily female (79%). Key cancer survivorship topics included adjusting to a "new normal," staying connected with cancer peers, and dealing with post-treatment medical care. Perceptions of YA survivorship research were mixed. YAs appreciated and were optimistic about the potential for benefit from research. Specific barriers for participation included perceptions of research being inaccessible, overwhelming, and frustrating; participation as inconvenient and burdensome; and researchers being viewed with skepticism and mistrust. They recommended: (1) making age-appropriate, patient-focused changes (e.g., language and design of study materials); (2) increasing participants' control, flexibility, and convenience of procedures; and (3) creating a back-and-forth dialogue between YAs and researchers. CONCLUSION: We assessed YA survivors' perceptions of YA cancer survivorship and research. Communication strategies are needed to address negative perceptions and perceived barriers to research participation. This includes tailoring of dissemination efforts and developmentally targeted implementation of YA priorities into the research process. Age-specific, patient-focused research practices may foster trust within the YA cancer survivor community and improve research participation.

Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey.

BACKGROUND: Many interventions find that social media engagement with health promotion materials can translate into behavioral changes. However, only a few studies have examined the ways in which specific actions on various social media platforms are correlated with health behaviors. OBJECTIVE: The objective of this study was to examine the association between social media use and HIV testing behaviors among Chinese men who have sex with men (MSM). METHODS: In July 2016, a Web-based survey was conducted to recruit MSM in 8 Chinese cities through Blued (Blue City Holdings Ltd.), the world's largest gay mobile phone app. Data on sociodemographic variables, social media use platforms and behaviors, sexual behaviors, and HIV testing histories were collected. HIV testing-related social media use was defined as having ever engaged with HIV testing content on social media, which was further divided into observing (ie, receiving), endorsing (eg, liking and sharing), and contributing (eg, posting or commenting on HIV testing materials). Confirmatory factor analysis (CFA) was conducted to determine the best division of HIV testing-related social media use. Univariate and multivariable logistic regressions were used to examine the association between HIV testing-related social media use and HIV testing behaviors. RESULTS: A total of 2105 individuals participated in the survey. Among them, 46.75% (984) were under the age of 24 years, 35.43% (746) had high school education or less, and 47.74% (587) had condomless sex in the last 3 months. More than half of the respondents (58.14%, 1224/2105) reported HIV testing-related social media use. Additionally, HIV testing-related social media use, especially on multifunctional platforms such as WeChat, was found to be associated with recent HIV testing (adjusted odds ratio [aOR] 2.32, 95% CI 1.66-3.24). Contributing on social media was correlated with recent HIV testing (aOR 2.10, 95% CI 1.40-3.16), but neither observing (aOR 0.66, 95% CI 0.38-1.15) nor endorsing (aOR 1.29, 95% CI 0.88-1.90) were correlated. CONCLUSIONS: Our data suggest that social media use, particularly on multifunctional platforms such as WeChat and with contributing behaviors, is correlated with HIV testing among MSM in China. Campaigns that promote active participant contribution on social media beyond passive observation and endorsement of promotional materials are needed. This study has implications for the design and implementation of social media interventions to promote HIV testing.

E-Cigarette Social Media Messages: A Text Mining Analysis of Marketing and Consumer Conversations on Twitter.

BACKGROUND: As the use of electronic cigarettes (e-cigarettes) rises, social media likely influences public awareness and perception of this emerging tobacco product. OBJECTIVE: This study examined the public conversation on Twitter to determine overarching themes and insights for trending topics from commercial and consumer users. METHODS: Text mining uncovered key patterns and important topics for e-cigarettes on Twitter. SAS Text Miner 12.1 software (SAS Institute Inc) was used for descriptive text mining to reveal the primary topics from tweets collected from March 24, 2015, to July 3, 2015, using a Python script in conjunction with Twitter's streaming application programming interface. A total of 18 keywords related to e-cigarettes were used and resulted in a total of 872,544 tweets that were sorted into overarching themes through a text topic node for tweets (126,127) and retweets (114,451) that represented more than 1% of the conversation. RESULTS: While some of the final themes were marketing-focused, many topics represented diverse proponent and user conversations that included discussion of policies, personal experiences, and the differentiation of e-cigarettes from traditional tobacco, often by pointing to the lack of evidence for the harm or risks of e-cigarettes or taking the position that e-cigarettes should be promoted as smoking cessation devices. CONCLUSIONS: These findings reveal that unique, large-scale public conversations are occurring on Twitter alongside e-cigarette advertising and promotion. Proponents and users are turning to social media to share knowledge, experience, and questions about e-cigarette use. Future research should focus on these unique conversations to understand how they influence attitudes towards and use of e-cigarettes.