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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (31 December 2019) | Viewed by 157174

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Special Issue Editors

Dr. Michael Stellefson

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Guest Editor

Department of Health Education & Promotion, East Carolina University, Greenville, NC 27858, USA
Interests: web-based patient education; evaluation of interactive health communication tools; chronic disease self-management; assessment of electronic health (eHealth) literacy

Prof. Dr. J. Don Chaney

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Guest Editor

Chair, Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA
Interests: distance education; educational technologies in health education/promotion

Prof. Dr. Beth H. Chaney

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Guest Editor

Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA
Interests: measurement; evaluation of community-based research; social media in health promotion and disease management; alcohol use and misuse among college student populations

Dr. Samantha R. Paige

E-Mail Website
Guest Editor

Doxy.me Research, Doxy.me, LLC, Rochester, NY 14623, USA
Interests: tobacco-associated lung disease care continuum; computer-mediated communication; cognitive and affective message processing; measurement
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Special Issue Information

Dear Colleagues,

The use of social media in public health education/promotion has been increasing due, in part, to its ability to remove physical access and geographical barriers for users. Specifically, social media provide an outlet to increase and promote translational health communication strategies and effective dissemination of health information and data in ways that allow users to not only utilize, but also create and share pertinent health information. Although social media applications in public health and health promotion have yielded success in terms of generating support structures and networks for effective health behavior change, there are challenges and complications associated with use of social media that also need to be addressed (e.g., managing misinformation, ensuring compliance with privacy protections). This Special Issue aims to explore social media as a translational health promotion tool by bridging principles of health education and health communication. Broadly, this Special Issue is seeking original submissions that examine: (1) The method with which social media users access, negotiate, and create health information that is both actionable and impactful for diverse audiences; (2) strategies for overcoming challenges to using social media in health promotion; and (3) best practices for designing, implementing, and/or evaluating social media campaigns and forums in public health. Special interest will be given to innovative submissions that expand and build upon traditional health education approaches with health communication theories and models. Other manuscript types of interest include relevant position papers, brief reports, and commentaries.

Prof. Dr. Michael Stellefson
Prof. Dr. J. Don Chaney
Prof. Dr. Beth H. Chaney
Dr. Samantha R. Paige
Guest Editors

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Keywords

Social media
Translational health communication
Online social networking
Health education
Health promotion
Participative engagement
eHealth literacy
Online health information-seeking behaviors
Consumer health informatics
Online community

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Published Papers (12 papers)

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Editorial

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5 pages, 237 KiB

Open AccessEditorial

Social Media and Health Promotion

by Michael Stellefson, Samantha R. Paige, Beth H. Chaney and J. Don Chaney

Int. J. Environ. Res. Public Health 2020, 17(9), 3323; https://doi.org/10.3390/ijerph17093323 - 11 May 2020

Cited by 25 | Viewed by 7181

Abstract

With over 3 billion users worldwide, social media has become a staple of daily life for people across the globe [...] Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

Research

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14 pages, 777 KiB

Open AccessArticle

The Direct and Indirect Effects of Online Social Support, Neuroticism, and Web Content Internalization on the Drive for Thinness among Women Visiting Health-Oriented Websites

by Nikol Kvardova, Hana Machackova and David Smahel

Int. J. Environ. Res. Public Health 2020, 17(7), 2416; https://doi.org/10.3390/ijerph17072416 - 2 Apr 2020

Cited by 9 | Viewed by 6027

Abstract

One of the debates about media usage is the potential harmful effect that it has on body image and related eating disturbances because of its representations of the “ideal body”. This study focuses on the drive for thinness among the visitors of various health-oriented websites and online platforms because neither has yet been sufficiently studied in this context. Specifically, this study aims to bring more insight to the risk factors which can increase the drive for thinness in the users of these websites. We tested the presumption that web content internalization is a key factor in this process, and we considered the effects of selected individual factors, specifically the perceived online social support and neuroticism. We utilized survey data from 445 Czech women (aged 18–29, M = 23.5, SD = 3.1) who visited nutrition, weight loss, and exercise websites. The results showed a positive indirect link between both perceived online social support and neuroticism to the drive for thinness via web content internalization. The results are discussed with regard to the dual role of online support as both risk and protective factor. Moreover, we consider the practical implications for eating behavior and weight-related problems with regard to prevention and intervention. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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14 pages, 3276 KiB

Open AccessArticle

Cultural Differences in Tweeting about Drinking Across the US

by Salvatore Giorgi, David B. Yaden, Johannes C. Eichstaedt, Robert D. Ashford, Anneke E.K. Buffone, H. Andrew Schwartz, Lyle H. Ungar and Brenda Curtis

Int. J. Environ. Res. Public Health 2020, 17(4), 1125; https://doi.org/10.3390/ijerph17041125 - 11 Feb 2020

Cited by 12 | Viewed by 5568

Abstract

Excessive alcohol use in the US contributes to over 88,000 deaths per year and costs over $250 billion annually. While previous studies have shown that excessive alcohol use can be detected from general patterns of social media engagement, we characterized how drinking-specific language varies across regions and cultures in the US. From a database of 38 billion public tweets, we selected those mentioning “drunk”, found the words and phrases distinctive of drinking posts, and then clustered these into topics and sets of semantically related words. We identified geolocated “drunk” tweets and correlated their language with the prevalence of self-reported excessive alcohol consumption (Behavioral Risk Factor Surveillance System; BRFSS). We then identified linguistic markers associated with excessive drinking in different regions and cultural communities as identified by the American Community Project. “Drunk” tweet frequency (of the 3.3 million geolocated “drunk” tweets) correlated with excessive alcohol consumption at both the county and state levels (r = 0.26 and 0.45, respectively, p < 0.01). Topic analyses revealed that excessive alcohol consumption was most correlated with references to drinking with friends (r = 0.20), family (r = 0.15), and driving under the influence (r = 0.14). Using the American Community Project classification, we found a number of cultural markers of drinking: religious communities had a high frequency of anti-drunk driving tweets, Hispanic centers discussed family members drinking, and college towns discussed sexual behavior. This study shows that Twitter can be used to explore the specific sociocultural contexts in which excessive alcohol use occurs within particular regions and communities. These findings can inform more targeted public health messaging and help to better understand cultural determinants of substance abuse. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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16 pages, 1248 KiB

Open AccessArticle

The Perceived Availability of Online Social Support: Exploring the Contributions of Illness and Rural Identities in Adults with Chronic Respiratory Illness

by Samantha R. Paige, Rachel E. Damiani, Elizabeth Flood-Grady, Janice L. Krieger and Michael Stellefson

Int. J. Environ. Res. Public Health 2020, 17(1), 242; https://doi.org/10.3390/ijerph17010242 - 29 Dec 2019

Cited by 6 | Viewed by 3680

Abstract

Joining an online social support group may increase perceived membership to a community, but it does not guarantee that the community will be available when it is needed. This is especially relevant for adults with Chronic Obstructive Pulmonary Disease (COPD), many of whom reside in rural regions and continually negotiate their illness identity. Drawing from social support literature and communication theory of identity, this cross-sectional study explored how COPD illness and geographic identities interact to influence patients’ perceived availability of online social support. In April 2018, 575 adults with a history of respiratory symptoms completed an online survey. Patients with a COPD diagnosis reported greater availability of online support. This was partially mediated by a positive degree of COPD illness identity (i.e., being diagnosed with COPD, a history of tobacco use, severe respiratory symptoms, high disease knowledge, and low income but high education). The relationship between COPD illness identity and the availability of online support was strongest among those with low rural identity; however, at lower levels of COPD illness identity, participants with high rural identity reported the greatest degree of available online support. Results have important implications for tailored education approaches across the COPD care continuum by illness and geographic identities. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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13 pages, 700 KiB

Open AccessArticle

How Health Communication via Tik Tok Makes a Difference: A Content Analysis of Tik Tok Accounts Run by Chinese Provincial Health Committees

by Chengyan Zhu, Xiaolin Xu, Wei Zhang, Jianmin Chen and Richard Evans

Int. J. Environ. Res. Public Health 2020, 17(1), 192; https://doi.org/10.3390/ijerph17010192 - 27 Dec 2019

Cited by 139 | Viewed by 38521

Abstract

During the last two decades, social media has immersed itself into all facets of our personal and professional lives. The healthcare sector is no exception, with public health departments now capitalizing on the benefits that social media offers when delivering healthcare education and communication with citizens. Provincial Health Committees (PHCs) in China have begun to adopt the micro-video sharing platform, Tik Tok, to engage with local residents and communicate health-related information. This study investigates the status quo of official Tik Tok accounts managed by PHCs in mainland China. In total, 31 PHC accounts were analyzed during August 2019, while the top 100 most liked micro-videos were examined using content analysis. Coding included three major aspects: Quantified Impact, Video Content, and Video Form. 45.2% (n = 14) of PHCs had official Tik Tok accounts. A limited number of accounts (n = 2) were yet to upload a micro-video, while most (n = 9) had uploaded their first micro-video during 2019. For the top 100 most liked micro-videos, a sharp difference was observed in terms of number of Likes, Comments and Reposts. Videos containing cartoons or documentary-style content were most frequently watched by citizens. Similarly, content that promoted professional health or provided knowledge of diseases was frequently viewed. Content containing original music, formal mandarin language, subtitles, and which lasted less than 60 s, were most frequently followed. It is considered a missed opportunity that most PHCs struggle to take advantage of the Tik Tok platform, especially given its growing popularity and daily increase in account creation. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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13 pages, 3078 KiB

Open AccessArticle

Finding Users’ Voice on Social Media: An Investigation of Online Support Groups for Autism-Affected Users on Facebook

by Yuehua Zhao, Jin Zhang and Min Wu

Int. J. Environ. Res. Public Health 2019, 16(23), 4804; https://doi.org/10.3390/ijerph16234804 - 29 Nov 2019

Cited by 53 | Viewed by 7405

Abstract

The trend towards the use of the Internet for health information purposes is rising. Utilization of various forms of social media has been a key interest in consumer health informatics (CHI). To reveal the information needs of autism-affected users, this study centers on the research of users’ interactions and information sharing within autism communities on social media. It aims to understand how autism-affected users utilize support groups on Facebook by applying natural language process (NLP) techniques to unstructured health data in social media. An interactive visualization method (pyLDAvis) was employed to evaluate produced models and visualize the inter-topic distance maps. The revealed topics (e.g., parenting, education, behavior traits) identify issues that individuals with autism were concerned about on a daily basis and how they addressed such concerns in the form of group communication. In addition to general social support, disease-specific information, collective coping strategies, and emotional support were provided as well by group members based on similar personal experiences. This study concluded that Latent Dirichlet Allocation (LDA) is feasible and appropriated to derive topics (focus) from messages posted to the autism support groups on Facebook. The revealed topics help healthcare professionals (content providers) understand autism from users’ perspectives and provide better patient communications. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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19 pages, 1089 KiB

Open AccessArticle

Effect of Emotion, Expectation, and Privacy on Purchase Intention in WeChat Health Product Consumption: The Mediating Role of Trust

by Ming-Yan Wang, Peng-Zhu Zhang, Cheng-Yang Zhou and Neng-Ye Lai

Int. J. Environ. Res. Public Health 2019, 16(20), 3861; https://doi.org/10.3390/ijerph16203861 - 12 Oct 2019

Cited by 49 | Viewed by 8767

Abstract

With the aging of the population and the upgrading of the consumption structure of national health demand in China, it has become a new trend for the public to actively seek health products and services on social networks. Based on the theory of reasoned behavior and the theory of expectancy confirmation, this study aims to analyze the cognitive factors and their effects on WeChat users’ purchase intention in the process of health product consumption. Considering that safety is a key feature of health products that distinguishes them from other consumer products, the “satisfaction” concept in the expectancy confirmation model is replaced by “trust” in this study. Two hundred and two (202) valid samples were collected by a questionnaire survey to analyze their intentions to buy health products on WeChat. Theoretical models and corresponding research hypotheses were verified by structural equation modeling. The research results show that emotional price and emotional experience are positively correlated with trust and purchase intention. There is an obvious negative correlation between privacy invasion and trust. Expectation confirmation is positively associated with trust. Moreover, the intermediary test shows that trust has completely mediated between emotional price and purchase intention, and trust also has a full intermediary effect on expectation confirmation and purchase intention. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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17 pages, 481 KiB

Open AccessEditor’s ChoiceArticle

Facebook Groups on Chronic Obstructive Pulmonary Disease: Social Media Content Analysis

by Avery Apperson, Michael Stellefson, Samantha R. Paige, Beth H. Chaney, J. Don Chaney, Min Qi Wang and Arjun Mohan

Int. J. Environ. Res. Public Health 2019, 16(20), 3789; https://doi.org/10.3390/ijerph16203789 - 9 Oct 2019

Cited by 31 | Viewed by 6996

Abstract

Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available on COPD-related Facebook Groups, as well as the communication (self-disclosures, social support) and engagement (agreement, emotional reaction) strategies used by members to facilitate these resources. Two researchers independently searched the “Groups” category using the terms “COPD”, “emphysema”, and “chronic bronchitis”. Twenty-six closed (n = 23) and public (n = 3) COPD Facebook Groups were identified with 87,082 total members. The vast majority of Group members belonged to closed (n = 84,684; 97.25%) as compared to open (n = 2398; 2.75%) groups. Medications were the most commonly addressed self-management topic (n = 48; 26.7%). While overall engagement with wall posts was low, the number of “likes” (an indicator of agreement) was significantly greater for wall posts that demonstrated social support as compared to posts that did not (p < 0.001). Findings from this study showed that COPD Facebook group members share specific disease-related experiences and request information about select self-management topics. This information can be used to improve the quality of self-management support provided to members of popular COPD Facebook groups. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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18 pages, 345 KiB

Open AccessFeature PaperArticle

Moving Beyond the Gym: A Content Analysis of YouTube as an Information Resource for Physical Literacy

by Trevor Bopp, Joshua D. Vadeboncoeur, Michael Stellefson and Melissa Weinsz

Int. J. Environ. Res. Public Health 2019, 16(18), 3335; https://doi.org/10.3390/ijerph16183335 - 10 Sep 2019

Cited by 30 | Viewed by 6333

Abstract

The Internet, and particularly YouTube, has been found to be and continues to develop as a resourceful educational space for health-related information. Understanding physical literacy as a lifelong health-related outcome and facilitator of an active lifestyle, we sought to assess the content, exposure, engagement, and information quality of uploaded physical literacy videos on YouTube. Two researchers collected 300 YouTube videos on physical literacy and independently coded each video’s: title, media source of upload, content topics related to physical literacy, content delivery style, and adherence to adapted Health on the Net Foundation Code of Conduct (HONcode) principles of information quality. Physical literacy videos that focused on physical activity and behaviors were the strongest predictor of high quality ratings, followed closely by videos covering affective domains (motivation, confidence, and self-esteem) of physical literacy. The content delivery method was also important, with videos utilizing presentations and testimonials containing high quality information about physical activity. Thus, providers of physical literacy and health-related online video content should be aware of and adhere to the expected quality standards. As health information expectations and ethical standards increase, the Internet, and specifically YouTube, has the potential to enhance video resources, virtual networking opportunities, as well as the sharing, dissemination, accumulation, and enrichment of physical literacy information for all. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

15 pages, 638 KiB

Open AccessArticle

Social Media-Based Health Management Systems and Sustained Health Engagement: TPB Perspective

by Dongxiao Gu, Jingjing Guo, Changyong Liang, Wenxing Lu, Shuping Zhao, Bing Liu and Tianyue Long

Int. J. Environ. Res. Public Health 2019, 16(9), 1495; https://doi.org/10.3390/ijerph16091495 - 27 Apr 2019

Cited by 50 | Viewed by 7206

Abstract

Background: With the popularity of mobile Internet and social networks, an increasing number of social media-based health management systems (SocialHMS) have emerged in recent years. These social media-based systems have been widely used in registration, payment, decision-making, chronic diseases management, health information and medical expenses inquiry, etc., and they greatly facilitate the convenience for people to obtain health services. Objective: This study aimed to investigate the factors influencing sustained health engagement of SocialHMS by combining the theory of planned behavior (TPB) with the big-five theory and the trust theory. Method: We completed an empirical analysis based on the 494 pieces of data collected from Anhui Medical University first affiliated hospital (AMU) in East China through structural equation modeling and SmartPLS (statistical analysis software). Results: Openness to new experience has a significantly positive influence on attitude (path coefficient = 0.671, t = 24.0571, R² = 0.451), perceived behavioral control (path coefficient = 0.752, t = 32.2893, R² = 0.565), and perceived risk (path coefficient = 0.651, t = 18.5940, R² = 0.424), respectively. Attitude, perceived behavioral control, subjective norms, and trust have a significantly positive influence on sustained health engagement (path coefficients = 0.206, 0.305, 0.197, 0.183 respectively, t = 3.6684, 4.9158, 4.3414, and 3.3715, respectively). The explained variance of the above factors to the sustained health engagement of SocialHMS is 60.7% (R² = 0.607). Perceived risk has a significantly negative influence on trust (path coefficient = 0.825, t = 46.9598, R² = 0.681). Conclusions: Attitude, perceived behavioral control, subjective norm, and trust are the determinants that affect sustained health engagement. The users’ personality trait of openness to new experience and perceived risk were also found to be important factors for sustained health engagement. For hospital managers, there is the possibility to take appropriate measures based on users’ personality to further enhance the implementation and utilization of SocialHMS. As for system suppliers, they can provide the optimal design for SocialHMS so as to meet users’ needs. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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10 pages, 686 KiB

Open AccessCommentary

Practical and Ethical Considerations for Schools Using Social Media to Promote Physical Literacy in Youth

by Trevor Bopp and Michael Stellefson

Int. J. Environ. Res. Public Health 2020, 17(4), 1225; https://doi.org/10.3390/ijerph17041225 - 14 Feb 2020

Cited by 17 | Viewed by 8582

Abstract

The rapid development of social media has led to its increased use by children and adolescents for health and well-being purposes. Accordingly, social interactions resulting from social media use can be further integrated into physical and health education pedagogy. Given the relationship between increased physical literacy and positive health outcomes, best practices and lessons learned from social media use in the healthcare industry should be adopted by health and physical educators practicing in schools. Thus, the purpose of this paper is to comment on several practical and ethical challenges and opportunities associated with using social media to improve physical literacy among youth. Specifically, two of the most prominent issues are discussed in depth: (1) integration of social media in physical education settings that educate children and adolescents about the biopsychosocial effects of physical activity, and (2) use of wearable technologies among youth to accrue experiences that enhance physical literacy competencies. In our opinion, health and physical educators who utilize the ALL-ENGAGE Playbook described in this commentary will successfully reach, engage, and impact students with popular social media that adequately promotes physical literacy, including through experiential use of wearable technologies. Full article

(This article belongs to the Special Issue Exploring the Role of Social Media in Health Promotion)

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7 pages, 280 KiB

Open AccessCommentary

Evolving Role of Social Media in Health Promotion: Updated Responsibilities for Health Education Specialists

by Michael Stellefson, Samantha R. Paige, Beth H. Chaney and J. Don Chaney

Int. J. Environ. Res. Public Health 2020, 17(4), 1153; https://doi.org/10.3390/ijerph17041153 - 12 Feb 2020

Cited by 195 | Viewed by 47660

Abstract

The use of social media in public health education has been increasing due to its ability to remove physical barriers that traditionally impede access to healthcare support and resources. As health promotion becomes more deeply rooted in Internet-based programming, health education specialists are tasked with becoming more competent in computer-mediated contexts that optimize both online and offline consumer health experiences. Generating a better understanding of the benefits and drawbacks to using social media in the field is important, since health education specialists continue to weigh its advantages against potential concerns and barriers to use. Accordingly, this Special Issue aims to explore social media as a translational health promotion tool by bridging principles of health education and health communication that examine (1) the method with which social media users access, negotiate, and create health information that is both actionable and impactful for diverse audiences; (2) strategies for overcoming challenges to using social media in health promotion; and (3) best practices for designing, implementing, and evaluating social media forums in public health. In this commentary, we discuss the updated communication and advocacy roles and responsibilities of health education specialists in the context of social media research and practice. Full article

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