Guidance on the use of social media in reproductive medicine practice.

The term "social media" refers to computer-mediated technologies that enable individuals and communities to gather, communicate, network, and share information. These technologies represent useful tools for enabling individual providers and their clinics to broadcast content that educates, informs, advertises, and narrates content to a larger audience. There are multiple benefits to maintaining a presence on social media, either as an individual physician or as a clinic, but several pitfalls deserve consideration as well. This guidance document does not endorse any specific cloud-based platform or service, though some are mentioned for the purposes of illustration.

Society for Assisted Reproductive Technology advertising guidelines: How are member clinics doing?

OBJECTIVE: To examine whether Society for Assisted Reproductive Technology (SART) member in vitro fertilization (IVF) centers adhere to the Society's new advertising policy, updated in January 2018, and evaluate other services advertised by region, insurance mandate and university affiliation status. Historically, a large percentage of IVF clinics have not adhered to SART guidelines for IVF clinic website advertising and have had variability in how financial incentives and other noncore fertility services are advertised. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Adherence of SART participating websites to objective criteria from the 2018 SART advertising guidelines. RESULT(S): All 361 SART participating clinic websites were evaluated. Approximately one third of clinics reported success rate statistics directly on their websites, but only 52.6% of those clinics reported current statistics. Similarly, only 67.5% of SART member clinics included the required disclaimer statement regarding their outcome statistics. Only 10.5% of websites were wholly compliant with SART guidelines regarding presentation of supplemental data. There were no significant differences between academic and nonacademic centers, programs in mandated versus nonmandated states, or East versus West Coast clinics in any of these areas. CONCLUSION(S): Many of the SART member websites failed to adhere to core guidelines surrounding reporting IVF clinic success rates. Consideration for additional education and streamlining as well as simplifying success rate advertising guidelines is recommended.

Industry Actor Use of Research Evidence: Critical Analysis of Australian Alcohol Policy Submissions.

OBJECTIVE: Governments' limited adoption of evidence-based policies to reduce alcohol-related harm has been partly attributed to alcohol industry influence. A better understanding of industry political strategy may help protect public policy against vested interests. We examined how industry actors used scientific evidence in their submissions to government alcohol policy consultations. METHOD: We conducted a content analysis of 214 submissions from industry actors in 21 Australian public consultations between 2013 and 2017. Represented industry actors included alcohol producers and retailers, trade associations, licensees, and associated entities that derive commercial benefit from alcohol (e.g., advertising companies). Adapting an existing framework, we classified industry practices into two categories: (a) misuse of evidence and (b) denial of the effectiveness of evidence-based strategies. RESULTS: Almost all submissions (91%) denied the effectiveness of evidence-based strategies; the most common denial practices were making unsubstantiated claims about adverse effects of policies (76%) and promoting alternatives without evidence (71%). The misuse of scientific evidence was apparent in 66% of submissions. Trade associations, producers, and retailers were most likely to use such practices. CONCLUSIONS: The extent to which the examined industry actors misused scientific evidence in their submissions to a wide range of alcohol policy consultations in Australia suggests the need for governments to consider excluding the industry from consultation on the regulation of alcohol.

Understanding the Extent of Adolescents' Willingness to Engage With Food and Beverage Companies' Instagram Accounts: Experimental Survey Study.

BACKGROUND: Social media platforms have created a new advertising frontier, yet little is known about the extent to which this interactive form of advertising shapes adolescents' online relationships with unhealthy food brands. OBJECTIVE: We aimed to understand the extent to which adolescents' preferences for Instagram food ads are shaped by the presence of comments and varying numbers of "likes." We hypothesized that adolescents would show the highest preferences for ads with more "likes" and comments. We predicted that these differences would be greater among adolescents who were "heavy social media users" (ie, >3 hours daily) vs "light social media users" (ie, <3 hours daily). METHODS: We recruited Black and non-Latinx White adolescents (aged 13-17 years; N=832) from Dynata, a firm that maintains online participant panels. Participants completed an online survey in which they were randomized to view and rate Instagram food ads that either did or did not show comments. Within each condition, adolescents were randomized to view 4 images that had high (>10,000), medium (1000-10,000), or low (<100) numbers of "likes." Adolescents reported ad preferences and willingness to engage with the brand. RESULTS: Adolescents rated ads with medium or high numbers of "likes" higher than ads with few "likes" (P=.001 and P=.002, respectively). Heavy social media users (>3 hours/day) were 6.366 times more willing to comment on ads compared to light users (P<.001). CONCLUSIONS: Adolescents interact with brands in ways that mimic interactions with friends on social media, which is concerning when brands promote unhealthy products. Adolescents also preferred ads with many "likes," demonstrating the power of social norms in shaping behavior. As proposed in 2019, the Children's Online Privacy and Protection Act should expand online advertising restrictions to include adolescents aged 12 to 16 years.

Quality of advertisements for prescription drugs in family practice medical journals published in Australia, Canada and the USA with different regulatory controls: a cross-sectional study.

OBJECTIVE: To assess if different forms of regulation lead to differences in the quality of journal advertisements. DESIGN: Cross-sectional study. PARTICIPANTS: Thirty advertisements from family practice journals published from 2013 to 2015 were extracted for three countries with distinct regulatory pharmaceutical promotion systems: Australia, Canada and the USA. PRIMARY AND SECONDARY OUTCOME MEASURES: Advertisements under each regulatory system were compared concerning three domains: information included in the advertisement, references to scientific evidence and pictorial appeals and portrayals. An overall ranking for advertisement quality among countries was determined using the first two domains as the information assessed has been associated with more appropriate prescribing. RESULTS: Advertisements varied significantly for number of claims with quantitative benefit (Australia: 0.0 (0.0-3.0); Canada: 0.0 (0.0-5.0); USA: 1.0 (0.0-6.0); p=0.01); statistical method used in reporting benefit (relative risk reduction, absolute risk reduction and number needed to treat; Australia: 6.7%, n=2; Canada: 10.0%, n=3; USA: 36.6%, n=11; p=0.02); mention of adverse effects, warnings or contraindications (Australia: 13.3%, n=4; Canada: 23.3%, n=7; USA: 53.3%, n=16; p=0.002); equal prominence between safety and benefit information (Australia: 25.0%, n=1; Canada: 28.6%, n=2; USA: 75.0%, n=12; p=0.04); and methodological quality of references score (Australia: 0.4150 (0.25-0.70); Canada: 0.25 (0.00-0.63); USA: 0.25 (0.00-0.75); p<0.001). The USA ranked first, Canada second and Australia third for overall quality of journal advertisements. Significant differences for humour appeals (Australia: 3.3%, n=1; Canada: 13.3%, n=4; USA: 26.7%, n=8; p=0.04), positive emotional appeals (Australia: 26.7%, n=8; Canada: 60.0%, n=18; USA: 50.0%, n=15; p=0.03), social approval portrayals (Australia: 0.0%, n=0; Canada: 0.0%, n=0; USA: 10.0%, n=3; p=0.04) and lifestyle or work portrayals (Australia: 43.3%, n=13; Canada: 50.0%, n=15; USA: 76.7%, n=23; p=0.02) were found among countries. CONCLUSIONS: Different regulatory systems influence journal advertisement quality concerning all measured domains. However, differences may also be attributed to other regulatory, legal, cultural or health system factors unique to each country.

Estereotipos de género en la publicidad gráfica a través de folletos promocionales de las grandes cadenas de supermercados de Argentina / Gender stereotypes in graphic advertising through promotional brochures in the main supermarket chains in Argentina

FUNDAMENTOS: Hablar de equidad de género requiere de abordar estereotipos perjudiciales, donde a menudo se perpetúan a través de la publicidad. El objetivo del estudio fue explorar la construcción y reproducción de estereotipos de género presentes en la publicidad gráfica a través de folletos promocionales en las principales cadenas de supermercados de la Ciudad Autónoma de Buenos Aires (CABA), Argentina. MÉTODOS: Se desarrolló una metodología cualitativa usando análisis documental y muestreo intencional. Se recolectaron folletos de 8 principales cadenas de supermercados de la CABA durante 3 meses (960 páginas de folletos). RESULTADOS: Los hallazgos indican que existen marcados estereotipos de género en las publicidades impresas donde se representó a las mujeres en roles pasivos y tradicionales como madre-cuidadora y ama de casa; esta tendencia se vio asimismo en publicidades orientadas a la población infantil. La representación de hombres fue con actividades diferenciales y roles activos. Se observaron representaciones vinculadas a la mujer madre, cuidadora y ama de casa y al modelo de familia tradicional en torno a aspectos alimentarios. CONCLUSIONES: Se concluye que en las publicidades gráficas a través de folletos promocionales existen estereotipos de género sexistas, sin observar una evolución positiva hacia otros patrones de género, inclusión y diversidad

BACKGROUND: Talking about gender equity recquires facing stereotypes counterproductive, often perpetuated through publicity. The objective of the study was to explore the construction and reproduction of gender stereotypes present in graphic advertising through promotional brochures in the main supermarket chains in Buenos Aires (CABA), Argentina. METHODS: A qualitative methodology was developed, usingdocumentary analysis and intentional sampling. Promotional brochures were gathered from 8 supermarket chains of the CABA, along three consecutive months (960 pages). RESULTS: The findings of this study indicate that there are noticeable gender stereotypes in print advertisements (brochures), where women were represented in passive and traditional roles as mother-caregiver and housewife, a trend which was also seen in advertisements aimed at children. Representation of men included differential activities and more active roles. Representations related to the woman mother, caregiver and housewife and the traditional family model regarding food aspects were observed. CONCLUSIONS: It is concluded that there are sexist gender stereotypes in graphic advertising through promotional brochures, without any positive evolution towards other gender patterns, inclusion and diversity

Small is beautiful, but large is certified: A comparison between fisheries the Marine Stewardship Council (MSC) features in its promotional materials and MSC-certified fisheries.

The Marine Stewardship Council (MSC) sets a standard by which sustainable fisheries can be assessed and eco-certified. It is one of the oldest and most well-known fisheries certifications, and an estimated 15% of global fish catch is MSC-certified. While the MSC is increasingly recognized by decision-makers as an indicator for fishery success, it is also criticized for weak standards and overly-lenient third-party certifiers. This gap between the standard's reputation and its actual implementation could be a result of how the MSC markets and promotes its brand. Here we classify MSC-certified fisheries by gear type (i.e. active vs. passive) as well as by length of the vessels involved (i.e. large scale vs. small scale; with the division between the two occurring at 12 m in overall length). We compared the MSC-certified fisheries (until 31 December 2017) to 399 photographs the MSC used in promotional materials since 2009. Results show that fisheries involving small-scale vessels and passive gears were disproportionately represented in promotional materials: 64% of promotional photographs were of passive gears, although only 40% of MSC-certified fisheries and 17% of the overall catch were caught by passive gears from 2009-2017. Similarly, 49% of the photographs featured small-scale vessels, although just 20% of MSC-certified fisheries and 7% of the overall MSC-certified catch used small-scale vessels from 2009 to 2017. The MSC disproportionately features photographs of small-scale fisheries although the catch it certifies is overwhelmingly from industrial fisheries.

Nutrimedia: A novel web-based resource for the general public that evaluates the veracity of nutrition claims using the GRADE approach.

The objective of Nutrimedia is to evaluate, based on the scientific evidence, the veracity of nutrition claims disseminated to the public by the media. In this article, we describe the methodology, characteristics and contents of this web-based resource, as well as its web traffic and media impact since it was launched. Nutrimedia uses a systematic process to evaluate common beliefs, claims from newspapers and advertising identified and selected by its research team, as well as questions from the public. After formulating a structured question for each claim, we conduct a pragmatic search, prioritizing guidelines and/or systematic reviews. We evaluate the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and classify the veracity of each claim into seven categories (true, probably true, possibly true, possibly false, probably false, false, and uncertain). For each evaluation, we develop a scientific report, a plain language summary, a summary of findings table, and, in some cases, a video. From November 2017 to May 2019, we published 30 evaluations (21 were related to foods, six to diets, and three to supplements), most of which were triggered by questions from the public (40%; 12/30). Overall, nearly half of the claims were classified as uncertain (47%; 14/30). Nutrimedia received 47,265 visitors, with a total of 181,360 pages viewed. The project and its results were reported in 84 written media and 386 websites from Spain and 14 other countries, mostly from Latin America. To our knowledge, Nutrimedia is the first web-based resource for the public that evaluates the certainty of evidence and the veracity of nutrition claims using the GRADE approach. The scientific rigor combined with the use of friendly presentation formats are distinctive features of this resource, developed to help the public to make informed choices about nutrition.

The role of social norms in the relationship between anti-smoking advertising campaigns and smoking cessation: a scoping review.

A systematic scoping review of anti-smoking mass media campaign literature provided opportunity to explore how social normative theories and constructs are used to influence smoking cessation. Synthesis of findings was constrained by significant heterogeneity. Nevertheless, the results indicate that a broader conceptualization of social norm is worthy of further exploration. Perceptions of what others think and do contributed in multiple ways to the relationship between anti-smoking messaging and quitting outcomes. Furthermore, integrating research on social norms, social identity and communication may improve understanding of why quitting intentions are enhanced in some circumstances but reactance and counter-arguing responses corresponding to lower quitting intentions occur in others. Integrating a broader theoretical understanding of normative influences into campaign development and evaluation may prove useful in demonstrating the effectiveness of this approach in behaviour change campaigns.

Assessment of Turkey IVF (In Vitro Fertilization) websites according to the American Society for Reproductive Medicine (ASRM)/Society for Assisted Reproductive Technology (SART) guidelines.

OBJECTIVE: To evaluate websites of in-vitro fertilisation centres in terms of standardised ethical guidelines for advertising. METHODS: The cross-sectional study was conducted in Turkey from February to April 2017. A total of 148 IVF centre websites were evaluated in terms of objective criteria in accordance with American Medical Association, American College of Obstetricians and Gynaecologists, American Society for Reproductive Medicine / Society for Assisted Reproductive. Technology guidelines for advertising. Websites were surveyed with attention paid to success rates, testimonials, sales promotions, price, psychological support offered as part of the service, regulating / certifying bodies, misleading language, and the ethical principles of autonomy, beneficence, non-maleficence and justice. Data was analysed using SPSS 23. RESULTS: Out of 193 centres, 148(76.7%) had active websites; 104(70.3%) private, 38(25.7%) in university hospitals and 6(4%) in state hospitals. Of them, 103(69.6%) centres used at least one example of misleading language when compared to the relevant guidelines. Among these centres, 82(79.6%) were private, 18(17.5%) university hospitals and 3(2.9%) were state hospitals. CONCLUSIONS: A massive majority of websites related to in-vitro fertilisation centres did not follow standardised guidelines for advertising.

Recruiting Research Participants via Traditional Snowball vs Facebook Advertisements and a Website.

This article describes the use of Facebook, a website targeting nurses, and snowball sampling for recruitment of registered nurse participants in a qualitative study exploring measurement-driven clinical behavior and metric-driven harm. Previous studies suggest that social media can be a successful and cost-effective sampling strategy, increasing the numbers of participants, their diversity, and their representativeness of the population of interest. This study, however, found traditional snowball sampling to be far more effective than advertisements via Facebook and a professional website. Lessons learned are detailed, including cost and technical issues encountered. Suggestions for nurse researchers considering using Facebook for participant recruitment are described. Methodological research that could enhance the empirical-base supporting effective social media recruitment of research participants is offered for consideration by nurse researchers.

The Impact of Advertisement Messaging on Enrollment of Young Men Who Have Sex With Men for Web-Based Research: Observational Study.

BACKGROUND: Recruiting young men who have sex with men (YMSM) in community settings is difficult. The use of Web-based social networks and dating apps for recruitment can be successful approaches, although little work has been done on the impact of study advertisement content on recruitment. OBJECTIVE: The aim of this study was to evaluate the effects of advertisement message content on the recruitment of YMSM (aged 18-26 years) for a Web-based focus group study, examining perspectives and preferences for a mobile app that was designed to support sexual health among YMSM. METHODS: Between March and April 2017, a recruitment campaign to promote human papillomavirus vaccination was launched on a popular social networking and dating app for YMSM, with 3 different text-based advertisement themes (technology, cancer prevention, and sexual innuendo). The campaign recruited YMSM across 3 states (Massachusetts, New York, and Pennsylvania). We examined the click-through rates, conversion rates, and enrollment rates of each of the advertisements and examined differences in views and clicks by age, state, and time of day. RESULTS: The sexual innuendo advertisement had the highest click rates when compared with both the technology (click rate ratio [CRR] 2.06, 95% CI 1.74-2.45) and cancer prevention (CRR 1.62, 95% CI 1.38-1.90) advertisements. The sexual innuendo advertisement also had higher study enrollment rates compared with the technology (CRR 1.90, 95% CI 1.23-2.83) and cancer prevention (CRR 2.06, 95% CI 1.37-3.13) advertisements. No differences were observed in clicks or enrollment by age, state, or time of day. CONCLUSIONS: Our marketing campaign, targeting YMSM, was effective in recruiting participants for a qualitative study, using Web-based focus groups. The sexual innuendo advertisement was the most effective and cost-efficient advertisement of the 3 approaches trialed. Different populations need different targeted strategies for study recruitment. Researchers should work with key representatives to develop and test culturally relevant messaging and approaches that utilize current and popular technologies.

Exposure and reach of the US court-mandated corrective statements advertising campaign on broadcast and social media.

OBJECTIVE: As a remedy to committing fraud and violating civil racketeering laws, in November 2017, four major tobacco companies were court-ordered to develop and disseminate corrective statements regarding smoking health risks using mass media channels. We aimed to describe the nature, timing, reach of and exposure to the court-mandated tobacco industry corrective advertising campaign on social, broadcast and print media. METHODS: Data from social, print and broadcast media were used to measure potential exposure to corrective messages. Keyword rules were used to collect campaign-related posts from the Twitter Firehose between November 2017 and January 2018. Data were analysed using a combination of machine learning, keyword algorithms and human coding. Posts were categorised by source (commercial/institutional, organic) and content type (eg, sentiment). Analysis of social media data was triangulated with ratings data for television advertising and print advertising expenditure data. RESULTS: Keyword filters retrieved 13 846 tweets posted by 9232 unique users. The majority of tweets were posted by institutional/commercial sources including news organisations, bots and tobacco control-related accounts and contained links to news and public health-related websites. Approximately 60% of campaign-related tweets were posted during the first week of campaign launch. Household exposure to the televised corrective advertisements averaged 0.56 ads per month. DISCUSSION: The corrective campaign failed to generate social media engagement. The size and timing of the advertising buys were not consistent with strategies effective in generating high sustained impact and audience reach, particularly among youth.

Optimizing Warnings on E-Cigarette Advertisements.

INTRODUCTION: We examined the effect of visual optimizations on warning text recall. METHODS: We used Amazon's Mechanical Turk to recruit 1854 young adult (18-34 years) electronic cigarette (e-cigarette) users or susceptible nonusers. We conducted a between-subjects 3 × 2 × 2 experiment to examine the influence of color (black text on white background [BW] vs. black on yellow [BY] vs. yellow on black [YB]), shape (rectangle vs. novel), and signal word (presence vs. absence of the word "warning"). We randomized participants to view one of 12 warnings on a fictional e-cigarette advertisement. We coded open-ended recall responses into three categories: (1) recalled nothing, (2) recalled something, (3) recalled the concept. We examined main effects on warning text recall using multinomial regression. We examined differences in attention, perceived message effectiveness, and appeal. RESULTS: Those exposed to BW or BY warnings were more likely than those exposed to YB to recall something (AOR = 1.6, AOR = 1.5, respectively) or the concept (OR = 1.4, BW). Those exposed to novel shape (44.7% novel vs. 37.9% rectangle; p = .003) or color (44.5% BY vs. 41.9% YB vs. 37.5% BW; p = .04) warnings were more likely to report attention to the warning. In aided recall, those exposed to the signal word were more likely than those not exposed to select the correct response (64.0% vs. 31.3%; p < .0001). We did not find differences for message effectiveness or appeal. CONCLUSIONS: Visual optimizations such as color may influence warning text recall and should be considered for new warnings. Research should continue exploring variations for advertisement warnings to maximize attention to warning text. IMPLICATIONS: This study examines the impact of visual optimizations on recall of the US Food and Drug Administration-mandated e-cigarette advertisement warning text. We found that color might influence warning text recall, but we did not find effects for shape or signal word. It is possible the newly mandated e-cigarette advertisement warnings, which are required to occupy at least 20% of the advertisement, are currently novel enough to attract attention. Future research should examine optimizations following implementation of the new advertisement warnings.

Regulación de la publicidad de alimentos y bebidas dirigida a la población infantil: el derecho a la información.

Objetivo. Documentar la evolución de los marcos reguladores de la publicidad de alimentos y bebidas no alcohólicas (PABNA) dirigida a la población infantil (PI) en México. Material y métodos. Revisión documental de las leyes, reglamentos y lineamientos encargados de regular la PABNA publicados en el Diario Oficial de la Federación (DOF) desde 1926 hasta 2016. Resultados. Se revisaron 18 documentos del DOF, se identificaron ventajas y limitaciones que tienen los marcos reguladores respecto a la PABNA dirigida a la PI y cómo se ha adecuado la regulación a los cambios en los medios de comunicación. Conclusiones. Es necesario implementar una regulación estricta sobre la PABNA dirigida a la PI, la cual evite mensajes que promuevan el consumo de productos de baja calidad nutrimental, relacionados con el incremento de prevalencias de sobrepeso, obesidad y enfermedades crónicas.

Legal and Ethical Analysis of Advertising for Elective Egg Freezing.

This paper reviews common advertising claims by egg freezing companies and evaluates the medical evidence behind those claims. It then surveys legal standards for truth in advertising, including FTC and FDA regulations and the First Amendment right to free speech. Professional standards for medical advertising, such as guidelines published by the American Society for Reproductive Medicine (ASRM), the American College of Obstetricians and Gynecologists (ACOG), and the American Medical Association (AMA), are also summarized. A number of claims, many of which relate to the targeting of younger women for eOC, are found to breach legal and ethical standards for truth in advertising. The ethical implications of misleading advertising claims are also discussed, and the central narrative woven by OC ads - that egg freezing is empowering to women - is examined. The paper concludes that a more balanced approach to the risks and benefits of OC is necessary to truly respect women's autonomy. Moreover, justice requires us to look beyond a medical procedure accessible only to a minority of women in order to address inequities in the workplace.