Machine learning and natural language processing to assess the emotional impact of influencers' mental health content on Instagram.

Background: This study aims to examine, through artificial intelligence, specifically machine learning, the emotional impact generated by disclosures about mental health on social media. In contrast to previous research, which primarily focused on identifying psychopathologies, our study investigates the emotional response to mental health-related content on Instagram, particularly content created by influencers/celebrities. This platform, especially favored by the youth, is the stage where these influencers exert significant social impact, and where their analysis holds strong relevance. Analyzing mental health with machine learning techniques on Instagram is unprecedented, as all existing research has primarily focused on Twitter. Methods: This research involves creating a new corpus labelled with responses to mental health posts made by influencers/celebrities on Instagram, categorized by emotions such as love/admiration, anger/contempt/mockery, gratitude, identification/empathy, and sadness. The study is complemented by modelling a set of machine learning algorithms to efficiently detect the emotions arising when faced with these mental health disclosures on Instagram, using the previous corpus. Results: Results have shown that machine learning algorithms can effectively detect such emotional responses. Traditional techniques, such as Random Forest, showed decent performance with low computational loads (around 50%), while deep learning and Bidirectional Encoder Representation from Transformers (BERT) algorithms achieved very good results. In particular, the BERT models reached accuracy levels between 86-90%, and the deep learning model achieved 72% accuracy. These results are satisfactory, considering that predicting emotions, especially in social networks, is challenging due to factors such as the subjectivity of emotion interpretation, the variability of emotions between individuals, and the interpretation of emotions in different cultures and communities. Discussion: This cross-cutting research between mental health and artificial intelligence allows us to understand the emotional impact generated by mental health content on social networks, especially content generated by influential celebrities among young people. The application of machine learning allows us to understand the emotional reactions of society to messages related to mental health, which is highly innovative and socially relevant given the importance of the phenomenon in societies. In fact, the proposed algorithms' high accuracy (86-90%) in social contexts like mental health, where detecting negative emotions is crucial, presents a promising research avenue. Achieving such levels of accuracy is highly valuable due to the significant implications of false positives or false negatives in this social context.

The Portrayal of Cesarean Section on Instagram: Mixed Methods Social Media Analysis.

BACKGROUND: Cesarean section (CS) rates in Indonesia are rapidly increasing for both sociocultural and medical reasons. However, there is limited understanding of the role that social media plays in influencing preferences regarding mode of birth (vaginal or CS). Social media provides a platform for users to seek and exchange information, including information on the mode of birth, which may help unpack social influences on health behavior. OBJECTIVE: This study aims to explore how CS is portrayed on Instagram in Indonesia. METHODS: We downloaded public Instagram posts from Indonesia containing CS hashtags and extracted their attributes (image, caption, hashtags, and objects and texts within images). Posts were divided into 2 periods-before COVID-19 and during COVID-19-to examine changes in CS portrayal during the pandemic. We used a mixed methods approach to analysis using text mining, descriptive statistics, and qualitative content analysis. RESULTS: A total of 9978 posts were analyzed quantitatively, and 720 (7.22%) posts were sampled and analyzed qualitatively. The use of text (527/5913, 8.91% vs 242/4065, 5.95%; P<.001) and advertisement materials (411/5913, 6.95% vs 83/4065, 2.04%; P<.001) increased during the COVID-19 pandemic compared to before the pandemic, indicating growth of information sharing on CS over time. Posts with CS hashtags primarily promoted herbal medicine for faster recovery and services for choosing auspicious childbirth dates, encouraging elective CS. Some private health facilities offered discounts on CS for special events such as Mother's Day and promoted techniques such as enhanced recovery after CS for comfortable, painless birth, and faster recovery after CS. Hashtags related to comfortable or painless birth (2358/5913, 39.88% vs 278/4065, 6.84%; P<.001), enhanced recovery after CS (124/5913, 2.1% vs 0%; P<.001), feng shui services (110/5913, 1.86% vs 56/4065, 1.38%; P=.03), names of health care providers (2974/5913, 50.3% vs 304/4065, 7.48%; P<.001), and names of hospitals (1460/5913, 24.69% vs 917/4065, 22.56%; P=.007) were more prominent during compared to before the pandemic. CONCLUSIONS: This study highlights the necessity of enforcing advertisement regulations regarding birth-related medical services in the commercial and private sectors. Enhanced health promotion efforts are crucial to ensure that women receive accurate, balanced, and appropriate information about birth options. Continuous and proactive health information dissemination from government organizations is essential to counteract biases favoring CS over vaginal birth.

Adding brief content-related information to sensitive-content screens does not exacerbate screen- or image-related distress.

Content descriptions presented on sensitive-content screens reduce how often people view negative images. But does this reduction in exposure come at an emotional cost? Across two experiments, we investigated this possibility. In Experiment 1, we compared participants' change in state anxiety when exposed to sensitive-content screens with and without brief and detailed content descriptions. State anxiety was similar for participants who saw screens with and without brief content descriptions, but we found larger increases in state anxiety for detailed content descriptions. Therefore, detailed content descriptions negatively impact how people feel when they view sensitive-content screens. In Experiment 2, we presented participants with a single sensitive-content screen, either with or without a brief content description, and gave them the opportunity to uncover it. Participants who uncovered the screen viewed the negative image and then rated their distress. Most participants uncovered the screen and, irrespective of condition, reported similar image-related distress. Taken together, brief descriptions do not negatively impact how people feel when they view sensitive-content screens or the forewarned content. Therefore, brief content descriptions do not create an emotional cost. Social media platforms should move beyond merely warning about upcoming content and provide brief content descriptions indicating what the content depicts.

Exploring arteriovenous malformations patient sentiments through 1401 social media posts.

INTRODUCTION: Social media has allowed patients with rare diseases to connect and discuss their experiences with others online. This study analyzed various social media platforms to better understand the patient's perception of arteriovenous malformation. METHODS: Twitter, Instagram, and TikTok were searched to find posts about patients' experiences with arteriovenous malformations (AVM). Posts unrelated to the patient's experience were excluded. Posts were coded for the relevant themes related to their experience with the disease, as well as engagement, and gender. RESULTS: The most common theme was raising awareness about the condition (87.0%). Recounting symptoms (50.2%), spreading positivity (17.5%), and survival (8.3%) were other common themes. Other prevalent themes were pain (5.2%) and fear of a rare disease (3.5%). Approximately half of AVM-related Instagram (47.93%) and TikTok (52.94%) posts raised awareness about the condition. Most Instagram (67.75%) and TikTok (89.71%) posts focused on recovery and rehabilitation. Most TikTok posts discussed "survival" or "death" (57.35%), while the majority focused on spreading positivity (79.41%). Most posts were made by women (69.6%). Females were more likely than males to post about the scientific explanation of AVMs (p = 0.003). CONCLUSION: Social media allows patients across the country and the globe to discuss their experiences with uncommon diseases and connect with others. It also allows AVM patients to share their experiences with other patients and the public.

#BrazilianButtLift: The Reel Problem Regarding Gluteal Augmentation Surgery.

NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

#nursing. What Nurses Do on Instagram- A Mixed Methods Study.

Background: Social media use is increasing every year, and nurses use social media to connect with each other. As Instagram was the most downloaded application in 2022 worldwide, this study focused on nurses' use of Instagram in the context of the development of a professional identity and in support of the professionalization of nursing. Objectives: The aim of the study was to find out how nurses use their Instagram profiles to influence their followers' professional identity and support the professionalization of nursing. Therefore, nurses' Instagram posts and the hashtags they used were analyzed. Methods: A visual content analysis to analyze different Instagram posts using a hierarchical cluster analysis, an ANOVA, and a qualitative content analysis were conducted. The most frequently used nursing-related hashtags were analyzed to include different Instagram profiles (n = 15) in the study. Results: This study identified three different clusters of Instagram profiles, which can be characterized as "Show me what you do," "Let's do education," and "The things we believe in." Consequently, it can be stated that nurses who display their values and beliefs in Instagram reels, half in nursing settings and half at home, have the highest number of followers and significantly more comments per post. The cluster that showed significantly more knowledge-based posts had the lowest number of followers and significantly the lowest number of comments. The content analysis of the hashtags used suggested that nurses who identify themselves as such want to attract attention from other nurses who use nursing-related hashtags. Conclusions: The results reveal that there is a possible benefit of the use of social media in the development of the nursing profession and professional identity. Followers and interactions can be generated when Instagram users identify with the profile and wish to discuss professional beliefs and values.

The Impact of Following Instagram Influencers on Women's Body Dissatisfaction and Eating Disorder Symptoms.

According to the Tripartite Influence Model, social media is one of the primary sources influencing women's body dissatisfaction. However, the role of social media influencers as a potential driver for impacting users' body image evaluation when disseminating content on social networks has been little investigated. The present research aims to explore the relationship between following three Instagram influencers (i.e., nutrition, fitness, and entertainment) and eating disorder (ED) symptoms and body dissatisfaction among a group of female users. A sample of 5060 women (mean age = 35.33 ± 9.33) were recruited with the collaboration of three Italian influencers, and self-reported questionnaires were administered. Women who followed the nutritional influencer account reported significantly higher scores on ED symptoms and body dissatisfaction than women who followed the fitness and entertainment influencer accounts (η2 = 0.05 and η2 = 0.02, respectively). Overall, following nutrition and fitness accounts (compared to entertainment accounts) and spending more time daily on social networks positively predicts ED symptoms (ß = 0.28, p < 0.001, ß = 0.10, p < 0.001, ß = 0.11, p < 0.001, respectively) and body dissatisfaction (ß = 0.07, p < 0.001, ß = 0.04, p < 0.001, ß = 0.07, p < 0.001, respectively). Moreover, following nutritional influencers compared to fitness influencers positively predicts ED symptoms (ß = 0.17, p < 0.001) but not body dissatisfaction. The current results suggest that being exposed to dieting and weight loss topics on social media might be particularly harmful for individuals with specific vulnerabilities. Practical implications will be discussed.

Assessing the Reach and Engagement Effectiveness of Disseminating Food and Nutrition Information on Social Media Channels.

This study utilized Facebook and Instagram as communication channels for disseminating evidence-based food and nutrition information to low-income adults. From February 2021 to October 2022, 442 identical posts were shared across both platforms for audience reach and engagement. Posts were categorized in two ways: hedonic and three levels of utilitarian (informative, convenience, utility), based on widely applied social media uses and effects theory (Uses and Gratifications Perspective); and food/nutrition topics (dietary guidance, mealtime behaviors, recipes, food resource management, health behaviors, and community building). From predominantly image-based posts (82.6%), reach and engagement for Instagram (136,621 versus 6096, respectively) outperformed Facebook (83,275 versus 1276, respectively). Analysis of covariance of rank-order reach and engagement metrics (likes, replies, shares) showed Facebook engagement was consistent across hedonic and utilitarian categories while Instagram showed highest reach and engagement for utilitarian posts, especially those emphasizing food affordability. Facebook and Instagram differed in which food/nutrition topics achieved maximal reach and engagement. Fifteen posts were randomly selected for qualitative analysis to identify features reflecting engagement levels. Low-engagement posts featured low-color-contrast or less-appealing images, especially on Instagram. This study offers insights for practitioners and researchers aiming to use social media to promote healthy food and nutrition.

Using an Instagram campaign to influence knowledge, subjective norms, perceived behavioral control, and behavioral intentions for sustainable behaviors.

Introduction: Climate change poses one of the most pervasive threats to the planet today. Intervention is required to promote pro-environmental behaviors among individuals to curb its effects. Borrowing several constructs from the Theory of Planned Behavior, we designed and evaluated a campaign, delivered primarily through Instagram, to shift sustainability-related cognitions and behaviors among university students. Methods: An online survey was distributed to undergraduate students at a Northern California university and collected responses from 1,552 participants. Results: Comparing students who self-reported exposure to the campaign with those who were not exposed, students who observed the campaign materials had more knowledge about (p < .001), greater perceived social norms about (p < .001), and greater intentions to perform sustainable behaviors (p < .001). There were also increases in sustainable behaviors during the campaign, compared to the previous academic term. Discussion: Implementing campaigns inspired by behavior change theories may be one viable strategy to increase individual sustainable behaviors for climate change mitigation.

Instagram reels versus image posts in radiology education.

OBJECTIVE: In January 2016, we created an Instagram page for radiology education. Numerous publications in different fields have reported that Instagram "reels," introduced in 2020 as a short-form video feature, are more popular than image posts. These findings and our familiarity with Instagram prompted us to analyze our own data to better understand how image posts compared with reels when used in the context of radiology education. MATERIALS AND METHODS: For each post category, metric values were extracted from the Instagram platform and analyzed as continuous variables, reported as medians with interquartile ranges (IQR). Metrics were compared between image categories using the Kruskal-Wallis test, with resulting p-values adjusted for multiple comparisons using the Bonferroni correction. Corrected p-values of less than 0.05 were considered statistically significant. RESULTS: We included 128 images and 96 reels in the analysis. Images generally reached a larger audience, with a median of 18,745 [IQR: 13,478-27,243] impressions vs. 11,972 [IQR: 9,310.0-13,844.5] for reels (p < 0.01). Images also tended to be shared more frequently (median 19 vs. 20, p < 0.01), liked more often (median 480 vs. 296, p < 0.01), and saved more by users (median 138 vs. 84, p < 0.01) than reels, respectively. Both images and reels received a similar number of comments, with a median of 3 comments for both (p > 0.99). We also explored the performance differences of image post subcategories. Within images, our "You Make the Call!" (YMTC) questions (n = 23) displayed higher performance metrics across the board than the three other types of image posts combined (n = 105). When compared, the median number of impressions for YMTC images was 36,735 [IQR: 31,343-40,742] vs. 15,992 [IQR:12,774-21,873] for other types of images (p < 0.01). YMTC images were shared more often (median 25 vs. 17, p < 0.01), received more likes (median 809 vs. 445, p < 0.01) and saves (median 206 vs. 119, p < 0.01) than non-YMTC images, respectively. User engagement showed slightly different trends with YMTC reels being the most liked, while quiz reels receiving the most comments and talking clips being the most saved. CONCLUSION: Our findings on the use of Instagram in radiology education suggest that static images perform much better than reels. Consequently, we recommend to radiology educators seeking to establish an Instagram presence that using static image posts is an appropriate approach for reaching a radiology audience, particularly with image posts that engage an audience with participatory opportunities such as answering quiz-like questions aimed at making a diagnosis.

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.

#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.

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.

The Association between Problematic Instagram Use, Psychological Distress, and Well-Being: A Systematic Review and Meta-Analysis.

Recent studies have indicated the potential detrimental psychological effects of Instagram use (IU) and problematic Instagram use (PIU). PIU and IU have been associated with depression, anxiety, and negative general well-being. This study aimed to investigate that correlation through a systematic review and meta-analysis. Seven databases, including PubMed/MEDLINE, were explored in February of 2023. Studies that assessed the association between IU and/or PIU with depression, anxiety, other psychological distresses, and/or general well-being were deemed eligible. The Hunter-Schmidt random effects model and multilevel meta-analysis were applied to assess the outcomes of interest. A total of 1,927 hits were identified with 37 studies included in the quantitative analysis after removal of duplicates and screening of abstracts and full texts, with the total number of participants at 14,305. The obtained correlations between PIU and depression, anxiety, and well-being with 95% confidence interval were found to be r = 0.35, [0.25, 0.44], r = 0.31, [0.22, 0.40], r = -0.17, [-0.24, -0.10], respectively. Similarly, for IU and depression r = 0.11, [0.06, 0.16], p < 0.05 for all of the aforementioned results. The association between IU and anxiety was found to be r = 0.12, [0.04, 0.21], p < 0.05. The present meta-analysis found significant conceptual heterogeneity across the studies included due to different study designs and population heterogeneity. The results show a positive association of PIU and IU with depression, anxiety, and other psychological distress(es). There is a need for robust designed longitudinal research to explore this association.

The Impact of Incentives on Data Collection for Online Surveys: Social Media Recruitment Study.

BACKGROUND: The use of targeted advertisements on social media platforms (eg, Facebook and Instagram) has become increasingly popular for recruiting participants for online survey research. Many of these surveys offer monetary incentives for survey completion in the form of gift cards; however, little is known about whether the incentive amount impacts the cost, speed, and quality of data collection. OBJECTIVE: This experiment addresses this gap in the literature by examining how different incentives in paid advertising campaigns on Instagram for completing a 10-minute online survey influence the response rate, recruitment advertising cost, data quality, and length of data collection. METHODS: This experiment tested three incentive conditions using three Instagram campaigns that were each allocated a US $1400 budget to spend over a maximum of 4 days; ads targeted users aged 15-24 years in three nonadjacent designated market areas of similar size to avoid overlapping audiences. Four ad creatives were designed for each campaign; all ads featured the same images and text, but the incentive amount varied: no incentive, US $5 gift card, and US $15 gift card. All ads had a clickable link that directed users to an eligibility screener and a 10-minute online survey, if eligible. Each campaign ran for either the full allotted time (4 days) or until there were 150 total survey completes, prior to data quality checks for fraud. RESULTS: The US $15 incentive condition resulted in the quickest and cheapest data collection, requiring 17 hours and ad spending of US $338.64 to achieve 142 survey completes. The US $5 condition took more than twice as long (39 hours) and cost US $864.33 in ad spending to achieve 148 survey completes. The no-incentive condition ran for 60 hours, spending nearly the full budget (US $1398.23), and achieved only 24 survey completes. The US $15 and US $5 incentive conditions had similar levels of fraudulent respondents, whereas the no-incentive condition had no fraudulent respondents. The completion rate for the US $15 and US $5 incentive conditions were 93.4% (155/166) and 89.8% (149/166), respectively, while the completion rate for the no-incentive condition was 43.6% (24/55). CONCLUSIONS: Overall, we found that a higher incentive resulted in quicker data collection, less money spent on ads, and higher response rates, despite some fraudulent cases that had to be dropped from the sample. However, when considering the total incentive amounts in addition to the ad spending, a US $5 incentive appeared to be the most cost-effective data collection option. Other costs associated with running a campaign for a longer period should also be considered. A longer experiment is warranted to determine whether fraud varies over time across conditions.

Endoscopic Spine Surgery on Instagram: Analysis of Content and Engagement.

Introduction Social media platforms have changed the way society communicates and collaborates. Prior research in healthcare discusses how social media can empower patients, dispel health-related misinformation, and help maintain a patient-centered practice. The goal of this study was to evaluate the use of #endoscopicspinesurgery on Instagram and create a blueprint for creating engaging posts on the social media platform. Methodology Public Instagram posts (n = 171) that utilized #endoscopicspinesurgery were collected over three months in 2022. Each post was assessed for photo and caption content, likes, comments, number of followers, and hashtag information. Engagement rates were calculated for each post to assess the active interaction of post characteristics and content. Results The majority of posts were published by medical professionals (72/171, 42.1%) and industry-related user accounts (55/171, 32.2%). Content related to training, conferences, and the operating room garnered the highest average engagement. Post characteristics (number of hashtags and number of post photos) were significantly associated with engagement. Conclusions Results highlighted general trends in creating engaging social media posts, such as using hashtags intentionally to increase searchability and visibility, having higher numbers of photos in a post and using high-quality photos, and understanding the dynamic social media algorithms that may affect post viewership. When structuring social media posts, users should be aware of the audience they want to attract and construct their content accordingly.

Insights on associations between the frequency of use of diverse social media products and social networks use disorder tendencies from a German speaking sample.

OBJECTIVE: In the present work we investigate how individual differences in at least occasionally using distinct social media platforms is linked to social networks use disorder (SNUD) tendencies. A final sample of n = 2200 participants filled in the AICA-C-9 measure to get insights into individual differences in overuse of social media and participants also indicated which platforms they used at least once a month. RESULTS: The analysis revealed a robust positive association between number of at least occasionally used social media apps and SNUD tendencies (r = .44, p < .001). Further, platforms differed in terms of their "addictive potential", if one takes associations between frequency of distinct platforms use and SNUD tendencies as a proxy for this (and of course the actual descriptive statistics of the SNUD scale for the (non-)frequent user groups of the different platforms). In this regard, at least occasionally using some platforms (here Tumblr, Twitter and TikTok) was associated with highest SNUD tendencies. Moreover, largest differences in terms of effect sizes between the occasional and non-occasional user groups regarding SNUD scores could be observed for Instagram, WhatsApp, and TikTok. The present work bases on data from a larger project investigating associations between SNUD and tobacco use disorder.

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.

Does so-called "healthy" content on instagram display balanced recipes? A pilot study in relation to the risk of unhealthy eating patterns in social network users.

OBJECTIVE: social networks (SN) including Instagram have increased in popularity. However, SN-mediated content may influence eating behaviors in a negative way. This study analyzed whether Instagram content claimed as "healthy" complies with nutritional guidelines. METHODS: recipes posted in French on Instagram with the caption #healthy or similar ones were analyzed, once from February to May 2023 and again in April 2024. Health authorities' guidelines and food pyramid inclusion criteria were used for the quantitative and qualitative analysis, respectively. Recipes were then classified as balanced, partially unbalanced or unbalanced, with the two subgroups "restrictive" and "excessive", and according to the main protein source. RESULTS: we coded a total of 114 courses (2 datasets of 57 courses each). Among these, 3 were classified as balanced main courses, 45 as partially unbalanced main courses and 66 as unbalanced main courses (21 were deemed as restrictive, 21 as excessive and 24 were otherwise inadequate), with a majority of hypocaloric courses. Approximately half of the recipes were vegetarian or vegan. DISCUSSION: these results suggest that food recipes published on Instagram as #healthy may, at times, be far from nutritional guidelines and could rather promote unbalanced eating patterns. This suggest that food-related content on SN might be insufficiently moderated and that recipes referenced as #healthy should perhaps be accompanied by warnings and preventive measures. This observation, in addition to other detrimental behaviors displayed on SN (e.g. extreme physical activity or body image pressure) may contribute to the increased incidence of eating disorders (ED) associated with problematic SN use. Alerts on this risk and accessible tools for the prevention and early detection of ED risk in SN users are urgently needed.