The effects of Facebook and Instagram on the 2020 election: A deactivation experiment.

We study the effect of Facebook and Instagram access on political beliefs, attitudes, and behavior by randomizing a subset of 19,857 Facebook users and 15,585 Instagram users to deactivate their accounts for 6 wk before the 2020 U.S. election. We report four key findings. First, both Facebook and Instagram deactivation reduced an index of political participation (driven mainly by reduced participation online). Second, Facebook deactivation had no significant effect on an index of knowledge, but secondary analyses suggest that it reduced knowledge of general news while possibly also decreasing belief in misinformation circulating online. Third, Facebook deactivation may have reduced self-reported net votes for Trump, though this effect does not meet our preregistered significance threshold. Finally, the effects of both Facebook and Instagram deactivation on affective and issue polarization, perceived legitimacy of the election, candidate favorability, and voter turnout were all precisely estimated and close to zero.

Content analysis of oral (mouth) cancer-related posts on Instagram.

OBJECTIVE: To examine the content of Instagram posts about oral cancer and assess its usefulness in promoting oral cancer awareness and early detection practices. METHODS: A systematic search of Instagram for posts about oral (mouth) cancer was conducted using the hashtags #oral cancer and #mouth cancer. Posts usefulness in promoting awareness and early detection was assessed using the early detection usefulness score, and caption readability was assessed using the Flesch Kincaid readability score. RESULTS: A total of 81,000 posts were identified, and 200 posts were thoroughly evaluated. Included posts gathered a total of 48,118 (mean = 420.59 likes) and 27,898 views. Most posts (81.5%) were educational to the lay person, and India and the UK were the major contributors. The most discussed topics were prevention and early detection (55%). Representative clinical images were present in 35.5% of posts. Only 9.5% of posts mentioned the source of information, and the mean usefulness score was only 2.1 out of 10. The mean reading ease score was 56.7 ± 43.8 (range from 1 to 98 out of 100). CONCLUSION: Instagram shows potential for promoting oral cancer awareness, particularly in prevention and early detection. However, concerns regarding content quality, scientific validity, and clarity persist.

Instagram for audience engagement: an evaluation of CERC framework in the GCC nations for digital public health during the Covid-19 pandemic.

BACKGROUND: In this study, we investigate the utilization of Instagram by public health ministries across the Gulf Cooperation Council (GCC) nations to disseminate health-related information during the COVID-19 pandemic. With Instagram's visual-centric approach and high user engagement, the research aims to investigate its critical yet complex role in information dissemination amid a health crisis. METHODS: To examine how Instagram communication strategies align with the CDC's Crisis and Emergency Risk Communication (CERC) framework, we employ the content analysis method. This approach helps to evaluate the effectiveness and challenges of employing Instagram for health communication within a region known for its significant social media usage. RESULTS: Findings indicate that Instagram serves as a vital platform for the rapid dissemination of health information in the GCC, leveraging its visual capabilities and wide reach. The GCC ministries of health utilized Instagram to demonstrate a consistent and strategic approach to communicate essential COVID-19 related information. Kuwait and Bahrain were the most active of all the assessed ministries with respect to the number of engagement metrics (likes and comments). Most of the posts, as per the CERC framework, were informational and related to vaccine infection and death cases. The second most salient theme in line with the CERC framework was about promoting actions, followed by Instagram posts about activities, events, and campaigns. CONCLUSIONS: The research underscores Instagram's potential as a powerful tool in enhancing public health resilience and responsiveness during health emergencies in the GCC. It suggests that leveraging social media, with careful consideration of its affordances, can contribute significantly to effective health communication strategies in times of crisis.

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.

#clearaligners and social media: An in-depth analysis of clear aligners' content on Instagram.

BACKGROUND AND OBJECTIVES: Clear aligners-related posts are popularized on social media platforms to educate patients and peers and to market aligners in dental practices. This study aimed to characterize the account credentials and content of the top-performing posts to understand the spread of clear aligners-related information on Instagram. MATERIALS AND METHODS: This cross-sectional web-based study analysed 13 Instagram clear aligners-related hashtags. Content analysis was performed for the "Top 10 posts" listed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's algorithm. Data were analysed for the poster's background, credentials, role, post format, content, and engagement level ratio. Duplicate posts and those not relevant to clear aligners were excluded. Quantitative and qualitative analyses of the collected data were conducted. RESULTS: A total of 29 192 596 posts mentioned the selected hashtags, of which 130 posts were screened in this study. Most posts were authored by dentists (n = 84), 79.8% of them were orthodontic specialists. Self-promotional posts comprised 90.2%, while educational posts accounted for only 8.9%. Interestingly, the number of likes and comments received on posts by patients (n = 19, median = 112, IQR = 340) was significantly higher than those posted by dentists (n = 84, median = 93, IQR = 81.75) (P = .004). CONCLUSION: More than 29 million posts about clear aligners were identified on Instagram. Orthodontists are the leading authors of aligners hashtags. However, the majority of the posts are self-promotional and have nonfactual information. Social media awareness among orthodontic specialists may help provide more evidence-based content about clear aligners and can act as an interactive networking and health communication platform.

The relationship between mothers' Instagram follower count and the concept of sharenting.

BACKGROUND: The phenomenon of sharenting has led to an increase in children's digital presence on social media platforms, particularly Instagram. This study aimed to examine the relationship between features of mothers' Instagram use and their sharing of photos related to their children. METHODS: The present study was conducted with 130 mothers of children who applied to our university hospital and who had an Instagram account and allowed us to follow them. The mothers completed an online questionnaire that consisted of parents' sociodemographic data and data regarding social media use characteristics. We created a new Instagram account for this study, and we examined the mothers' Instagrams via this account. The number of Instagram followers was analyzed by dividing it into four equal 25% percentiles. RESULTS: The present study found that mothers with more followers shared more photos about themselves and their children on Instagram per year (p < 0.001). It was confirmed that mothers with more followers were more likely to share their children's photos showing them alone, showing them playing, photos that included identity information, and photos that violated their privacy (p values respectively; p = 0.004, p = 0.001, p = 0.043, p = 0.015). CONCLUSIONS: This study highlights the association between mothers' Instagram follower numbers and the presence of risky posts about their children on social media. The number of Instagram followers might serve as a predictor of sharenting behavior. The study's findings are discussed thoroughly, and recommendations are provided for future research and practice in this area.

Female genital cosmetic surgery in Indonesia: a qualitative analysis of medical advertising on Instagram.

Research on female genital cosmetic surgery usually comes from Anglophone countries. We investigated female genital cosmetic surgery in the predominantly Muslim South-East Asian country of Indonesia, aiming to identify the procedures offered by medical clinics on Instagram, how they are justified, and what they claim to achieve; and to understand what this means for women and their bodies. The 184 eligible posts from 19 clinics between 1 January to 31 March 2021 offered vaginoplasty, labiaplasty, hymenoplasty, and other procedures. Reflexive thematic analysis yielded three themes: Why you should have female genital cosmetic surgery, Indications for female genital cosmetic surgery, and What you will gain from female genital cosmetic surgery. Posts were similar to those identified in other countries, revealing implicit vulvar aesthetics, expectations that women choose to 'improve' their genitals, the need to please men, and that female genital cosmetic surgery is straightforward. Two differences from Anglophone advertising were the use of euphemisms to describe the vulva and an emphasis on physical 'virginity'. Across countries, female genital cosmetic surgery advertising appears to arise from patriarchal constructs of women's bodies and determination to control them. We contend that Indonesia shares with other countries the need for education-of medical practitioners and the general public-about sexuality and the vulva, and that the advertising of female genital cosmetic surgery should be regulated and rigorously monitored.

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.

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.

Social Media Use and Patient Ratings in Shoulder and Elbow Surgeons: How Many 'Likes' for Five Stars?

INTRODUCTION: Social media plays an important role in healthcare and physician selection by facilitating direct communication with patients and impacting physician ratings. A concern however is the increased online scrutiny and negative impact on patient satisfaction with these connections. This study aimed to investigate whether social media activity by fellowship-trained shoulder and elbow surgeons impacts patient's perceptions and ratings on physician rating websites (PRWs). MATERIALS AND METHODS: The American Shoulder and Elbow Surgeons (ASES) physician directory was used to identify currently practicing shoulder and elbow surgeons in the US. Physician ratings were collected from Healthgrades, Google reviews, and Vitals. The surgeons were divided into two groups: social media users (SMU) and non-social media users (NSMU). The association of social media use with online physician ratings was evaluated using simple and multilinear regressions. RESULTS: A total of 385 ASES surgeons were included and 21.3% were SMU. SMU were younger (mean age, 48 years) compared to NSMU (mean age, 51 years) (p = 0.01), all other demographics were comparable including sex (p = 0.797), medical degree (MD or DO) (p = 0.114), and geographic location within the US (p = 0.49). SMU had significantly higher ratings on Healthgrades (p<0.001) and Vitals (p<0.001). However, social media use did not impact the total number of ratings on PRWs. Additionally, surgeons who utilized Facebook had higher physician ratings and number of website reviews on Healthgrades (p = 0.028 and p=0.014, respectively). In addition, surgeons who used Twitter had higher ratings on Healthgrades (p<0.001) and Vitals (p=0.001). Surgeons with a greater average number of likes per post on Twitter had significantly higher average ratings across all three sites (p=0.004). Surgeons with a greater number of Twitter followers and greater average number of likes per post had significantly higher average ratings on Healthgrades (p=0.052 and p=0.005, respectively) while surgeons with a greater average number of likes per post had significantly higher average ratings on Vitals (p=0.006). Finally, surgeons with a greater average posting frequency on Instagram had significantly higher average ratings across all websites (p=0.029). CONCLUSION: Shoulder and elbow surgeons who use Twitter and Facebook had significantly higher online ratings. However, the increased use of these platforms in terms of post content, post frequency, comments, and number of followers was not as influential on PRWs. This suggests that social media is an important marketing and outreach method for orthopedic surgeons to improve their ratings and patient reviews.

What are Board-Certified Plastic Surgeons Posting on Instagram?

BACKGROUND: Plastic surgeons increasingly use social media to market their practices and educate prospective patients. Previous studies have investigated plastic surgery content on Instagram from the angle of hashtags and most popular plastic surgeons. However, very little is understood about what plastic surgeons themselves post on Instagram and what plastic surgery content average users engage with. OBJECTIVES: The aim of this study was to analyze Instagram posts from accounts related to plastic surgeons in the USA to establish suggestions for growing one's practice with this powerful platform to reach patients. METHODS: Board-certified plastic surgeons from all US regions that were active from February 1, 2023 to April 12, 2023 were randomly chosen. Their Instagram accounts were accessed for post analysis. For procedural posts, engagement statistics and multiple variables were collected. Dixon's outlier test was used to determine outliers in the data. ANCOVA and Tukey analysis was used to determine whether procedure type influenced engagement. RESULTS: 120 surgeon accounts were identified with 2157 posts analyzed, yielding notable differences in posts among regions. Most posts were aesthetic procedures (94.4%) and of female patients (90.3%). Surgical procedures were also predominant (86.1%). In addition, Reels had higher engagement than photograph posts. Users engaged with Body procedures at the highest rate. CONCLUSIONS: This cross-sectional analysis shows plastic surgeons tend to overwhelmingly post female patients, aesthetic procedures, and surgical content. These insights may be used to guide social media content and improve the effectiveness of Instagram as a tool for marketing or education. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Changing to Impress: Testing a Mediation Model from Instagram Self-presentation to Cosmetic Surgery.

BACKGROUND: This study examined the relationship between false self-presentation on Instagram and consideration of cosmetic surgery through the mediating role of body image control in photos (BICP), photo manipulation, and body shame. We predicted that false self-presentation on Instagram was indirectly associated with cosmetic surgery intentions through the aforementioned constructs. METHODS: A total of 504 young Italian adults (28.2% males, 18-30 years) completed an online survey. They completed a questionnaire containing the Self-presentation on Instagram Questionnaire, the Body Image Control in Photos Questionnaire-revised, the Photo Manipulation Scale, the Objectified Body Consciousness Scale, and the Acceptance of Cosmetic Surgery Scale. The pattern of associations between the constructs was analyzed via path analysis. RESULTS: The results show that false self-presentation on Instagram was associated with photo manipulation, both directly and indirectly, through BICP. Furthermore, photo manipulation was linked to body shame, but neither of them was associated with cosmetic surgery intentions. Finally, false self-presentation on Instagram was associated with the consideration of cosmetic surgery only through the mediation of BICP. CONCLUSION: Findings indicate that self-presentation styles might affect Instagram photo behaviors and individuals' cosmetic surgery intentions, suggesting that surgeons should fully examine patients' motivations before providing them with services. Furthermore, intervention programs encouraging users to present a more authentic version of themselves online might reduce the risk of self-objectification and reduce the consideration of procedures aimed at modifying one's body for purely aesthetic reasons. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Appearance-based rejection sensitivity mediates the relationship between Instagram addiction and dysmorphic concerns in young adult women.

INTRODUCTION: Dysmorphic concerns refer to excessive preoccupations with one's physical characteristics. There is a need to better understand the factors associated with these experiences, especially in young adult women. Given emergent research suggesting a link between the use of Instagram, dysmorphic concerns, and appearance pressures, we tested a mediation model in which appearance-based rejection sensitivity mediated the relationship between Instagram addiction and dysmorphic concerns. METHODS: In this cross-sectional study, 300 young adult women from Romania with mean age of 22.19 years (SD = 2.07) and who possessed an Instagram account were asked to complete an online survey consisting of measures of dysmorphic concerns, Instagram addiction, and appearance-based rejection sensitivity. RESULTS: Correlational analyses revealed that all three variables were positively and moderately inter-correlated. Mediation analysis supported the hypothesis that appearance-based rejection sensitivity mediates the relationship between Instagram addiction and dysmorphic concerns. CONCLUSIONS: Implications of this study are discussed in terms of the urgency of prevention and intervention strategies, especially given the link between dysmorphic concerns and more extreme manifestations of severity, such as body dysmorphic disorder.

Reliability of social media data in monitoring the global pet trade in ants.

The global pet trade is a major risk to biodiversity and humans and has become increasingly globalized, diversified, digitalized, and extremely difficult to control. With billions of internet users posting online daily, social media could be a powerful surveillance tool. But it is unknown how reliably social media can track the global pet trade. We tested whether Instagram data predicted the geographic distribution of pet stores and the taxonomic composition of traded species in the emerging pet trade in ants (Hymenoptera, Formicidae). We visited 138 online stores selling ants as pets worldwide and recorded the species traded. We scraped ∼38,000 Instagram posts from ∼6300 users referencing ants as pets and analyzed comments on post and geolocation (available for ∼1800 users). We tested whether the number of Instagram users predicted the number of ant sellers per country and whether the species referenced as pets on Instagram matched the species offered in online stores, with a particular focus on invasive species. The location of Instagram users referencing ants as pets predicted the location of ant sellers across the globe (R2  = 0.87). Instagram data detected 439 of the 631 ant species traded in online stores (70%), including 59 of the 68 invasive species traded (87%). The number of Instagram users referencing a species was a good predictor of the number of sellers offering the species (R2  = 0.77). Overall, Instagram data provided affordable and reliable data for monitoring the emerging pet trade in ants. Easier access to these data would facilitate monitoring of the global pet trade and help implement relevant regulations in a timely manner.

El mercado global de mascotas es una amenaza importante para la biodiversidad y los humanos y cada vez está más globalizado, diversificado, digitalizado y muy difícil de controlar. Con miles de millones de usuarios publicando a diario en línea, las redes sociales podrían ser una herramienta poderosa de vigilancia, aunque no se sabe cuán confiable puede ser su rastreo del mercado global de mascotas. Analizamos si los datos de Instagram pronosticaban la distribución geográfica de las tiendas de mascotas y la composición taxonómica de las especies comercializadas en el mercado emergente de hormigas mascotas (Hymenoptera, Formicidae). Visitamos 138 tiendas virtuales dedicadas al comercio de hormigas como mascotas a nivel mundial y registramos las especies comercializadas. Reunimos ∼38,000 publicaciones de Instagram de ∼6,300 usuarios que mencionaban a las hormigas como mascotas y analizamos los comentarios en las publicaciones y la geolocalización (disponible para ∼1,800 usuarios). Analizamos si el número de usuarios de Instagram pronosticaba el número de vendedores de hormigas por país y si las especies mencionadas como mascotas en Instagram eran las mismas que aquellas ofrecidas en las tiendas en línea, con foco particular sobre las especies invasoras. La ubicación de los usuarios de Instagram que mencionaban a las hormigas como mascotas pronosticó la ubicación de los vendedores de hormigas alrededor del mundo (R2 = 0.87). La información de Instagram detectó 439 de las 631 especies de hormigas comercializadas en las tiendas virtuales (70%), incluidas 59 de las 68 especies invasoras comercializadas (87%). El número de usuarios de Instagram que mencionaba a una especie fue un buen indicador del número de vendedores que ofrecían esa eespecie (R2 = 0.77). En general, la información de Instagram proporcionó datos accesibles y confiables para el monitoreo del mercado emergente de hormigas mascotas. Un acceso más sencillo a estos datos facilitaría el monitoreo del mercado global de mascotas y ayudaría a implementar regulaciones relevantes de manera oportuna.

Women's body dissatisfaction, physical appearance comparisons, and Instagram use throughout the COVID-19 pandemic: A longitudinal study.

OBJECTIVE: This study aimed to determine the evolution of Instagram use, body dissatisfaction and physical appearance comparisons throughout the coronavirus disease-2019 (COVID-19) pandemic, and to explore whether there was a relationship between the changes in Instagram use throughout the pandemic and body dissatisfaction and physical appearance comparisons. METHOD: A total of 272 Spanish women (16-70 years old) were followed-up across four waves of assessment between November 2019 (before the pandemic started) and July 2021. Body dissatisfaction, social appearance comparisons, and Instagram use were assessed using the Eating Disorders Inventory-3, the Physical Appearance Comparison Scale-Revised, and an ad hoc questionnaire for Instagram use, respectively. RESULTS: No statistically significant changes were found in the frequency of Instagram use, nor on the proportion of women following appearance-focused accounts on Instagram, among the data collection periods. Body dissatisfaction significantly increased from T1 to T4, and physical appearance comparisons significantly increased from T1 to T2, T3, and T4. These increases were not found to be significant for those with eating disorder risk. No significant differences were found in body dissatisfaction and physical appearance comparisons depending on whether participants' frequency of Instagram use had changed or remained the same, or whether they had started/stopped/continued following appearance-focused accounts on Instagram during the pandemic. DISCUSSION: Women's body dissatisfaction and physical appearance comparisons seem to have increased throughout the pandemic. The experiences of individuals with eating disorder risk throughout the pandemic, and the relationship between the pandemic and Instagram use, might be complex and need further research. PUBLIC SIGNIFICANCE: This study suggests that women's body dissatisfaction and physical appearance comparisons have increased throughout the COVID-19 pandemic. However, this increase might not be as clear for those who had eating disorder risk before the pandemic. Instagram frequency of use, and the percentage of women following appearance-focused accounts on Instagram, do not seem to have significantly increased. More research is needed to explore the impact of the pandemic.

Comparison of Social Media Content on Hidradenitis Suppurativa: A Cross-Sectional Study.

BACKGROUND: Research has shown that patients may turn to social media seeking information regarding diagnosis and treatment. This study aimed to analyze and compare content related to hidradenitis suppurativa (HS) using the "hashtag" tool across three of the most popular social media platforms to determine the information that patients are exposed to online. METHODS: We identified hashtags across Instagram, TikTok, and Facebook for "#hidradenitissuppurativa." The top 50 videos returned by the algorithm across each site were selected for analysis. Data extracted for comparison included content creator demographics, number of followers, type of content (educational vs. noneducational), and associated hashtags. RESULTS: Sixty-seven percent of posts were created by females (n = 101/150), 10% by males (n = 16/150), and 22% other (n = 33/150). Distribution was similar across all platforms. User accounts on TikTok have a significantly higher number of followers (median = 38,700, range = 902-17,600,000 followers) compared to Facebook (median = 1,375, range = 58-777,000 followers) and Instagram (median = 2,818, range = 57-9,800 followers). CONCLUSION: This study suggests that there is a disproportionate number of patients creating content to raise awareness on HS on social media compared to patient support groups or medical professionals. We propose that social media is a useful platform that dermatologists and official institutional bodies can utilize as an alternative method of health promotion and patient education. Further research to explore social media trends across a range of dermatological conditions can help guide targeted education campaigns in the future.

#CoreCosmeticSpecialties: An analysis of nonsurgical cosmetic procedure hashtags on Instagram.

OBJECTIVES: In this study, we seek to characterize both the account credentials and content type for posts among the most popular nonsurgical cosmetic procedure hashtags on Instagram. METHODS: Twenty-five hashtags related to nonsurgical cosmetic procedures were identified with over 250,000 posts each, ranging from 256,000 to 12.1 million posts per hashtag. The first 10 posts displayed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's proprietary algorithm, were analyzed for account type and content type. Posts unrelated to the cosmetic procedure or with non-English captions were excluded. In total, 680 posts were queried with 250 posts meeting the inclusion criteria. RESULTS: Content creators included nonphysician providers (68%), core cosmetic physicians (12%), noncore cosmetic physicians (8%), and consumers or others (13%). Content type included before and after (45%), self-promotional (23%), educational (17%), personal (5%), entertainment (5%), and promotional (5%). Among the different content creator types, core cosmetic physicians had the largest proportion of educational content at 38%. CONCLUSIONS: High-quality educational content on Instagram from core cosmetic specialties is scarce. By increasing their presence on Instagram, core cosmetic physicians can provide patient education, counteract misinformation, and raise awareness on training and qualifications regarding nonsurgical cosmetic procedures.

Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts.

BACKGROUND: Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects. METHODS: This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages. RESULTS: Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κq) was high (Stage 1: 92% agreement [95% CI 87, 97], κq 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κq 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%). CONCLUSION: While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

The relationship between problematic Instagram use and eating disorders psychopathology: an explanatory structural equation model.

An emerging body of research has evidenced the negative influence of using and being exposed to social networking sites (SNSs) on body image. Furthermore, it has been postulated that SNS use might be related with onset and persistence of eating disorders (EDs) psychopathology. The aim of the present study is to evaluate the complex interplay between problematic Instagram use (PIU) (conceptualized as a potential behavioral addiction comprising withdrawal, conflict, tolerance, salience, mood modification and relapse) and ED psychopathology, by means of an explanatory structural equation model. We hypothesized that PIU would be associated with ED symptoms through the mediating role of appearance comparison, individual psychological investment in physical appearance, and body uneasiness. A sample of 386 young female participants (Mage = 26.04 ± 6.73) was recruited, of which 152 had received a diagnosis of ED. ED patients used Instagram more than the control group and showed higher levels of PIU. Results from structural equation modeling (fit indices: χ2 = 44.54, df = 19, p < 0.001; RMSEA = 0.059; CFI = 0.98; SRMR = 0.02) showed that PIU predicted appearance comparison and psychological investment in physical appearance, which in turn predicted body uneasiness. In turn, body uneasiness predicted ED psychopathology and interpersonal difficulties. Our model provides a useful account of how eating disorder symptoms could be triggered and maintained by an addictive use of Instagram.

Instagram-based priming to nudge drink choices: Subtlety is not the answer.

Instagram-based priming (e.g., subtly incorporating healthy drinks into the background of Instagram images) could potentially nudge healthier consumption behaviours. Given the negative health consequences associated with sugar-sweetened-beverage consumption, two experiments tested the effect of three sets of Instagram-based primes for nudging drink choices from a visual food and drinks display. Participants (18-25 years) were randomly assigned to view a series of Instagram advertising images (for technology, travel, or homeware products) that included a glass containing water (water prime) or cola (soft drink prime), or no drink (control). They then selected an item from the visual display containing snack foods and drinks. In Experiment 1 (n = 493) beverages were subtly incorporated into the priming images; in Experiment 2 (n = 471) beverages were made more prominent. Priming condition did not predict choice in Experiment 1 but did so in Experiment 2, where participants in the soft drink prime condition were significantly more likely to select a drink versus a food, compared to those in the water prime and control conditions. The water prime did not predict choice in either study. A greater percentage of participants noticed the beverage primes in Experiment 2 than in Experiment 1. Overall, it appears that when clearly visible, soft drinks incorporated into Instagram-style images can nudge drink choices. However, a less subtle approach may be needed to effectively encourage healthier drink choices.