Social Media Adoption in Local Health Departments Nationwide

Objectives. We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs.Methods. In 2012, we searched for Facebook and Twitter accounts for 2565 LHDs nationwide, and collected adoption date and number of connections for each account. Number of tweets sent indicated LHD use of social media. LHDs were classified as innovators, early adopters, or nonadopters. Characteristics of LHDs were compared across adoption categories, and we examined geographic characteristics, connections, and use.Results. Twenty-four percent of LHDs had Facebook, 8% had Twitter, and 7% had both. LHDs serving larger populations were more likely to be innovators, tweeted more often, and had more social media connections. Frequency of tweeting was not associated with adoption category. There were differences in adoption across geographic regions, with western states more likely to be innovators. Innovation was also higher in states where the state health department adopted social media.Conclusions. Social media has the potential to aid LHDs in disseminating information across the public health system. More evidence is needed to develop best practices for this emerging tool.Local health departments (LHDs) are charged with assuring their constituents receive 10 essential public health services.1 Among these services is Essential Service #3 (ES3): inform, educate, and empower people about health issues.1 The Public Health Accreditation Board has included communication with constituents about public health issues and health risks in a recently developed set of standards required of LHDs seeking accreditation.2 As of 2004, only 61% of LHDs were adequately addressing ES3.3One new communication tool that may aid LHDs in educating and informing their constituents and meeting accreditation standards is social media. Web-based social media sites, such as Facebook and Twitter, can facilitate direct, one-to-many communication with a large audience at little to no cost.4,5 Facebook accounts can be liked, and Twitter accounts can be followed by other users, including the general public, allowing individuals or organizations to receive and spread information posted by a source. A recent survey indicated that 65% of online adults in the United States, or half of all US adults, use social media.6 Facebook and Twitter are the most widely used social media platforms7; worldwide more than 845 million people use Facebook, whereas 140 million people are Twitter users.8 Each minute, 695 000 Facebook statuses are updated, and 98 000 tweets are sent.9In the United States, social media is used by many segments of the population. Although overall social media use among adults with Internet access is associated with age, it is independent of educational attainment, race/ethnicity, and health care access.10 Likewise, there are no significant differences in Twitter use by education or income; however, the use of Twitter is significantly higher among Black non-Hispanic Internet users (28%) compared with non-Hispanic White (12%) or Hispanic Internet users (14%).11 Twitter use is also significantly higher in young adults compared with older age groups and in urban and suburban locations compared with rural locations.Use of social media is emerging as a popular way to seek health information for the general public.12,13 For adult Internet users, the Internet is a primary source of health information, second only to health care providers; 80% of US Internet users (or 59% of US adults) have looked online for health information.14,15 Of adult social media users, 23% report following their friends’ personal health experiences or updates, 17% have used social media to remember or memorialize people with a specific health condition, and 15% have obtained health information from social media sites.15Social media platforms are also increasingly used by health care providers and public health organizations and practitioners to share information with each other during training16,17 and practice,18 and to reach consumers with health information.4,19–21 The World Health Organization has Facebook and Twitter accounts, as do the Centers for Disease Control and Prevention (CDC) and numerous health-related schools and departments, scientists, and health-focused news outlets.20 CDC has developed an online toolkit to aid public health practitioners in using social media to disseminate information and foster partnerships with consumers.5 Advocates of social media use in the health community believe social media outlets provide a place for dialogue with consumers,21 and a mechanism for real-time surveillance22 and rapid dissemination of time-sensitive health information.20,23 Challenges identified by health professionals include a lack of understanding of social media23 and the volume of information available online, which can confuse consumers.20Despite numerous barriers that often hinder the adoption of new technology in government organizations,4 studies indicate a majority of state health departments (60%–82%) are using at least 1 social media application.24,25 Those health departments using social media report using it daily to disseminate information on healthy behaviors and health conditions.25 In addition, in studies surveying a sample of LHDs nationwide, up to 30.9% reported having a Facebook page, whereas up to 47.0% reported using Twitter.26,27The adoption of Facebook and Twitter across the public health system constitutes a natural experiment providing insight into how technological innovations spread across this system. Given the potential of social media to reach a large segment of the adult population, many of whom are actively seeking health information online, it is important to better understand the adoption and use of this new tool by public health practitioners. To this end, we were the first that we know of to examine the adoption and use of Facebook and Twitter across all LHDs nationwide. Specifically, we examined whether characteristics of an LHD, and the state and region where it is located, were associated with adoption of social media. We also examined the number of followers or likes for each health department with a Facebook or Twitter account and whether followers and likes were associated with LHD characteristics. Finally, we examined the number of tweets per month for Twitter accounts as a general indicator of social media use by LHDs.     

Nonalcoholic fatty liver disease does not predict worse perioperative outcomes in bariatric surgery

Nonalcoholic fatty liver disease (NAFLD) occurs in 84–95% of obese individuals. Bariatric surgery (BS) is an effective treatment of obesity, with a potential sustained weight loss of 21–45%. The safety and efficacy of BS among NAFLD patients is not well established. The aim of this study was to determine outcomes for patients with NAFLD undergoing BS compared to patients without.MethodsAll adults undergoing BS were identified from the National Inpatient Sample 2012–2015 and stratified based on the presence of NAFLD using ICD-9/CPT codes. Primary outcomes included inpatient mortality, length of stay (LOS), and total hospital charges (THC). Secondary outcomes included infection, bleeding, improper wound healing and surgical revision.Results302,306 patients underwent BS, of which 15,607 had NAFLD and 286,699 did not (non-NAFLD). NAFLD patients had 35% lower inpatient mortality and shorter LOS, but slightly greater THC. NAFLD patients had smaller risk of improper wound healing and post-operative infection. There was no difference in bleeding, or incidence of surgical revision between groups.ConclusionNAFLD patients had lower mortality and complication rates following BS. A significant postsurgical weight loss should attenuate liver inflammation and fibrosis, and therefore has the potential to stop or even reverse progression of liver disease.     

High-priority liver transplantation and simultaneous sleeve gastrectomy in MELD 32 end-stage liver disease: a case report with long-term follow-up

BackgroundMorbid obesity is a worldwide epidemic closely linked to Non-Alcoholic Fatty Liver Disease (NAFLD), an ever more relevant indication for Liver Transplantation (LT). Obesity affects an increasing number of LT recipients, but the ideal management of these patients remain unclear. Bariatric surgery (BS) in LT setting is challenging but feasible, although the debate is still open about the best timing of bariatric surgery. Herein we report a case of high-priority LT and simultaneous sleeve gastrectomy (SG) in an obese young adult.Case reportA 45 years old man with morbid obesity (BMI 46 kg/m²) and severe NAFLD-related end-stage liver disease (ESLD) underwent simultaneous LT and sleeve gastrectomy (SG) in an emergency setting, due to a MELD score of 32. He had substantial weight loss during long-term follow-up and enjoyed resolution of diabetes and hypertension. At 4 years follow-up, he has normal allograft function with appropriate immunosuppressant blood levels and no ultrasound evidence of steatosis.ConclusionIn selected patients, combined LT and SG present several advantages in terms of transplant outcomes, weight loss and resolution of obesity-related comorbidities. In addition, it can be performed in the high-priority setting in case of severe ESLD with good results in the short- and long-term.     

Tweeting PP: an analysis of the 2015–2016 Planned Parenthood controversy on Twitter

ObjectivesWe analyzed Twitter tweets and Twitter-provided user data to give geographical, temporal and content insight into the use of social media in the Planned Parenthood video controversy.MethodologyWe randomly sampled the full Twitter repository (also known as the Firehose) (n=30,000) for tweets containing the phrase “planned parenthood” as well as group-defining hashtags “#defundpp” and “#standwithpp.” We used demographic content provided by the user and word analysis to generate charts, maps and timeline visualizations. Chi-square and t tests were used to compare differences in content, statistical references and dissemination strategies.ResultsFrom July 14, 2015, to January 30, 2016, 1,364,131 and 795,791 tweets contained “#defundpp” and “#standwithpp,” respectively. Geographically, #defundpp and #standwithpp were disproportionally distributed to the US South and West, respectively. Word analysis found that early tweets predominantly used “sensational” words and that the proportion of “political” and “call to action” words increased over time. Scatterplots revealed that #standwithpp tweets were clustered and episodic compared to #defundpp. #standwithpp users were more likely to be female [odds ratio (OR) 2.2, confidence interval (CI) 2.0–2.4] and have fewer followers (median 544 vs. 1578, p<.0001). #standwithpp and #defundpp did not differ significantly in their usage of data in tweets. #defundpp users were more likely to link to websites (OR 1.8, CI 1.7–1.9) and to other online dialogs (mean 3.3 vs. 2.0 p<.0001).ConclusionSocial media analysis can be used to characterize and understand the content, tempo and location of abortion-related messages in today's public spheres. Further research may inform proabortion efforts in terms of how information can be more effectively conveyed to the public.ImplicationsThis study has implications for how the medical community interfaces with the public with regards to abortion. It highlights how social media are actively exploited instruments for information and message dissemination. Researchers, providers and advocates should be monitoring social media and addressing the public through these modern channels.     

General Audience Engagement With Antismoking Public Health Messages Across Multiple Social Media Sites: Comparative Analysis

BackgroundPublic health organizations have begun to use social media to increase awareness of health harm and positively improve health behavior. Little is known about effective strategies to disseminate health education messages digitally and ultimately achieve optimal audience engagement.ObjectiveThis study aims to assess the difference in audience engagement with identical antismoking health messages on three social media sites (Twitter, Facebook, and Instagram) and with a referring link to a tobacco prevention website cited in these messages. We hypothesized that health messages might not receive the same user engagement on these media, although these messages were identical and distributed at the same time.MethodsWe measured the effect of health promotion messages on the risk of smoking among users of three social media sites (Twitter, Facebook, and Instagram) and disseminated 1275 health messages between April 19 and July 12, 2017 (85 days). The identical messages were distributed at the same time and as organic (unpaid) and advertised (paid) messages, each including a link to an educational website with more information about the topic. Outcome measures included message engagement (ie, the click-through rate [CTR] of the social media messages) and educational website engagement (ie, the CTR on the educational website [wCTR]). To analyze the data and model relationships, we used mixed effects negative binomial regression, z-statistic, and the Hosmer-Lemeshow goodness-of-fit test.ResultsComparisons between social media sites showed that CTRs for identical antitobacco health messages differed significantly across social media (P<.001 for all). Instagram showed the statistically significant highest overall mean message engagement (CTR=0.0037; 95% CI 0.0032-0.0042), followed by Facebook (CTR=0.0026; 95% CI 0.0022-0.0030) and Twitter (CTR=0.0015; 95% CI 0.0013-0.0017). Facebook showed the highest as well as the lowest CTR for any individual message. However, the message CTR is not indicative of user engagement with the educational website content. Pairwise comparisons of the social media sites differed with respect to the wCTR (P<.001 for all). Messages on Twitter showed the lowest CTR, but they resulted in the highest level of website engagement (wCTR=0.6308; 95% CI 0.5640-0.6975), followed by Facebook (wCTR=0.2213; 95% CI 0.1932-0.2495) and Instagram (wCTR=0.0334; 95% CI 0.0230-0.0438). We found a statistically significant higher CTR for organic (unpaid) messages (CTR=0.0074; 95% CI 0.0047-0.0100) compared with paid advertisements (CTR=0.0022; 95% CI 0.0017-0.0027; P<.001 and P<.001, respectively).ConclusionsOur study provides evidence-based insights to guide the design of health promotion efforts on social media. Future studies should examine the platform-specific impact of psycholinguistic message variations on user engagement, include newer sites such as Snapchat and TikTok, and study the correlation between web-based behavior and real-world health behavior change. The need is urgent in light of increased health-related marketing and misinformation on social media.     

Vaccine-related advertising in the Facebook Ad Archive

BackgroundIn 2018, Facebook introduced Ad Archive as a platform to improve transparency in advertisements related to politics and “issues of national importance.” Vaccine-related Facebook advertising is publicly available for the first time. After measles outbreaks in the US brought renewed attention to the possible role of Facebook advertising in the spread of vaccine-related misinformation, Facebook announced steps to limit vaccine-related misinformation. This study serves as a baseline of advertising before new policies went into effect.MethodsUsing the keyword ‘vaccine’, we searched Ad Archive on December 13, 2018 and again on February 22, 2019. We exported data for 505 advertisements. A team of annotators sorted advertisements by content: pro-vaccine, anti-vaccine, not relevant. We also conducted a thematic analysis of major advertising themes. We ran Mann-Whitney U tests to compare ad performance metrics.Results309 advertisements were included in analysis with 163 (53%) pro-vaccine advertisements and 145 (47%) anti-vaccine advertisements. Despite a similar number of advertisements, the median number of ads per buyer was significantly higher for anti-vaccine ads. First time buyers are less likely to complete disclosure information and risk ad removal. Thematically, anti-vaccine advertising messages are relatively uniform and emphasize vaccine harms (55%). In contrast, pro-vaccine advertisements come from a diverse set of buyers (83 unique) with varied goals including promoting vaccination (49%), vaccine related philanthropy (15%), and vaccine related policy (14%).ConclusionsA small set of anti-vaccine advertisement buyers have leveraged Facebook advertisements to reach targeted audiences. By deeming all vaccine-related content an issue of “national importance,” Facebook has further the politicized vaccines. The implementation of a blanket disclosure policy also limits which ads can successfully run on Facebook. Improving transparency and limiting misinformation should not be separate goals. Public health communication efforts should consider the potential impact on Facebook users’ vaccine attitudes and behaviors.     

A retrospective analysis of social media posts pertaining to COVID-19 vaccination side effects

ObjectivesWith an uprising influence of social media platforms like Twitter and Instagram a multitude of worldwide accessible information is available. Since the beginning of COVID-19 pandemic the exchange of medical information about several topics related to this infectious disease and its vaccination has increased rapidly. The purpose of this investigation was to assess the content associated with COVID-19 vaccination and its side effects and evaluate its educational quality.MethodsWe conducted this retrospective study to investigate 600 Twitter and Instagram posts by #covidvaccinesideeffects due to number of ‘likes’, comments, type of post, language, its purpose and source. In addition, posts were evaluated due to educational quality by three examiners of different educational levels.ResultsThe majority of posts showed 0 to 50 “likes” and 0 to 5 comments in English language. A comparison between Twitter and Instagram by the influence of application showed significant differences in number of posts and “likes” or comments (p < 0.05). The major post type were texts for Twitter (251; 83.7%) and videos for Instagram (104; 34.7%). While a majority of posts by #covidvaccinesideeffects report about the occurrence of side effects, the majority of them were mild and general COVID-19 vaccination feedback during the first 4 months was positive. But, only 3 to 7% were rated by “excellent” educational and validatable content. Interrater reliability between all three examiners presented a high concordance with 89% (p = 0.001).ConclusionsThis study presents an analysis of quantity and quality of social media content according to COVID-19 vaccinations and its side effects. It supports the deduction that most of the content on Twitter and Instagram is shared by patients and unclear sources and thus is limited informative. Nevertheless, influence of social media on medical information especially during COVID-19 pandemic is increasing and practitioners have to face its effect on their patients.     

Equidad y autonomía del paciente en las estrategias de atención a personas con enfermedades crónicas en los servicios de salud de España

ObjectiveTo examine the chronic care models of the different Spanish health services and to discuss the ethical questions derived from implementing some of their components.MethodNarrative review of care strategies and programmes for chronic patients in the different Autonomous Communities, searching in official health departments’ web pages, using the terms “Programmes”, “Strategies”, “Chronic patients”, and “Chronicity”.Results15 programmes were found. Most of them include all components of the chronic care model, “decision-making support” being under-represented. The main conflicts in the autonomy of patients arise from the use of big data to stratify the population and from telemonitoring. The stratification of population does not consider the social factors that accompany the disease.ConclusionsChronic care strategies should consider the autonomy and privacy of patients in the use of clinical data and telemonitoring. In order to be equitable, they would have to provide an integrated health care system, incorporating measures to reduce the inequalities due to the social determinants that accompany the disease.     

Dietary Pattern Classifications and the Association with General Obesity and Abdominal Obesity in Korean Women

ObjectivesThis study was done to identify dietary patterns and determine relationships between obesity and dietary patterns in Korean women.Subjects/methodsUsing 3,742 cases of baseline data from the Korean Health and Genome Study, dietary patterns were identified using factor analysis of data from a validated food frequency questionnaire. Relationships between dietary patterns and obesity were analyzed.ResultsFour dietary patterns were identified: (a) “animal food” (greater intake of meats and fish), (b) “rice-vegetable” (greater intake of steamed rice, tofu, Kimchi, vegetables, dried anchovy, and seaweeds), (c) “bread-dairy” (greater intake of bread, eggs, milk, and dairy products), and (d) “noodle” (greater intake of ramyun, noodles, and Chajangmyeon). The “animal food,” “bread-dairy,” and “noodle” dietary patterns were preferred by younger people with higher education levels (P<0.01), but the “rice-vegetable” dietary pattern was preferred by older people with lower incomes and education levels (P<0.01). In Korean women, dietary patterns were related to abdominal obesity but not obesity. The “rice-vegetable” and “noodle” dietary patterns were associated with an increased risk of abdominal obesity. However, the “bread-dairy” dietary pattern had an inverse relationship with abdominal obesity.ConclusionIn this study we identified four unique dietary patterns in Korean women that were independently associated with abdominal obesity. Abdominal obesity was positively related to the “rice-vegetable” and “noodle” dietary patterns. These finding may be useful in the development of dietary guidelines and the prevention of abdominal obesity in Korean women.     

Effects of Bariatric Surgery on Maternal and Infant Outcomes of Pregnancy—An Evidence Analysis Center Systematic Review

BackgroundWhile obesity presents specific acute and long-term risks to the pregnant woman and her offspring, the effects of bariatric surgery on pregnancy outcomes are undetermined.ObjectiveA systematic review was performed according to the Academy of Nutrition and Dietetics Evidence Analysis Library process to determine the effects of bariatric surgery on both maternal and infant health outcomes of pregnancy.DesignA comprehensive literature search of PubMed was conducted to identify studies published from years 2000 to 2015 that examined the health effects of pregnancy after bariatric surgery. Experimental studies and observational studies with a control group were included.Main outcome measuresOutcomes of interest were gestational weight gain, maternal complications (ie, gestational diabetes, pre-eclampsia, eclampsia, hypertension, and postpartum hemorrhage), miscarriage and/or stillbirth, cesarean section, birth weight in grams, birth weight in categories (ie, macrosomia, low birth weight, small for gestational age, and large for gestational age), gestational age and preterm birth, infant illness and complications (ie, perinatal death, admission to neonatal intensive care unit, neonatal illness, and congenital malformation rates), and Apgar scores.ResultsThirteen of 246 studies were included. Compared to body mass index–matched controls without surgery, bariatric surgery before pregnancy reduced infant birth weight in grams, with no effect on total maternal gestational weight gain or Apgar scores. Surgery did not increase risk of adverse outcomes, such as miscarriage and/or stillbirth, preterm birth, or infant complications. Effects of surgery on maternal complications, infant birth weight categories, and surgical delivery rates were inconsistent.ConclusionsBariatric surgery is a successful treatment of maternal obesity, but certain surgery-specific risks may exist. More data are needed to determine clinical guidelines. The long-term effects of surgery on pregnancy outcomes are unknown.     

Social Media Content of Idiopathic Pulmonary Fibrosis Groups and Pages on Facebook: Cross-sectional Analysis

BackgroundPatients use Facebook as a resource for medical information. We analyzed posts on idiopathic pulmonary fibrosis (IPF)-related Facebook groups and pages for the presence of guideline content, user engagement, and usefulness.ObjectiveThe objective of this study was to describe and analyze posts from Facebook groups and pages that primarily focus on IPF-related content.MethodsCross-sectional analysis was performed on a single date, identifying Facebook groups and pages resulting from separately searching “IPF” and “idiopathic pulmonary fibrosis.” For inclusion, groups and pages needed to meet either search term and be in English, publicly available, and relevant to IPF. Every 10th post was assessed for general characteristics, source, focus, and user engagement metrics. Posts were analyzed for presence of IPF guideline content, useful scientific information (eg, scientific publications), useful support information (eg, information about support groups), and potentially harmful information.ResultsEligibility criteria were met by 12 groups and 27 pages, leading to analysis of 523 posts. Of these, 42% contained guideline content, 24% provided useful support, 20% provided useful scientific information, and 5% contained potentially harmful information. The most common post source was nonmedical users (85%). Posts most frequently focused on IPF-related news (29%). Posts containing any guideline content had fewer likes or comments and a higher likelihood of containing potentially harmful content. Posts containing useful supportive information had more likes, shares, and comments.ConclusionsFacebook contains useful information about IPF, but posts with misinformation and less guideline content have higher user engagement, making them more visible. Identifying ways to help patients with IPF discriminate between useful and harmful information on Facebook and other social media platforms is an important task for health care professionals.     

A content analysis of the promotional strategies employed by e-cigarette brands on Twitter

Abstract

Cigarette smoking in the U.S. is declining, but e-cigarette (e-cig) use is rapidly expanding. E-cig brands utilize social media for promotion and have the autonomy to disseminate messages that encourage the use of their products. The current study categorized the most frequent strategies among popular e-cig brands on Twitter. A content analysis of over 1800 tweets was performed based on Philip Morris brand personality characteristics. Most tweets emphasized e-cigs’ economic value (24.2%) and normalized their use by portraying e-cigs as “cool” (23.1%). E-cig brands are employing similar strategies as tobacco companies and easily connecting to young adults through social media.     

Publication output of National Health Service Bariatric centres in England

Obesity has been identified as an independent risk factor for a wide range of health conditions. Therefore, there is a clear need for high quality Bariatric research in order to improve patient selection, outcomes and safety for patients with obesity. We sought to identify and compare the quantitative and qualitative publication output from Bariatric centres in England. We identified 42 National Health Service (NHS) Trusts and 162 surgeons providing Bariatric services in England. A median of 4 (range 1–7) Bariatric surgeons were identified per centre. Eight NHS Trusts (19%) and 75 surgeons (46.3%) had no Bariatric publications during the study period, while 87 surgeons published a total of 432 Bariatric papers. Only 15 surgeons (9%) had ≥10 publications within the study period. However, these surgeons produced >50% of all Bariatric publications. Departments with more than 4 surgeons produced a significantly higher number of Bariatric publications (median 8.5 vs 2, p = 0.01). There is significant variation in research contribution amongst Bariatric centres in England. Academia should be encouraged and promoted across all bariatric services in order to broaden our understanding on Bariatric outcomes by expanding the service and proportional increase in funding. Given that a number of health conditions can afflict individuals living with obesity, bariatric surgery research becomes all the more important.     

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ≥ 40 kg/m²) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95% CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.     

Physicians,patients, and Facebook: Could you? Would you? Should you?

ABSTRACT

This article investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook “friends” with patients and many (42%) were opposed to physicians having any kind of Facebook presence. Some believed that health care organizations should have a social media policy and provide social media training. We conclude with suggestions for how health care administrators can provide assistance to physicians and effectively manage their social media presence.     

Characteristics of Food Industry Web Sites and “Advergames” Targeting Children

ObjectiveTo assess the content of food industry Web sites targeting children by describing strategies used to prolong their visits and foster brand loyalty; and to document health-promoting messages on these Web sites.DesignA content analysis was conducted of Web sites advertised on 2 children's networks, Cartoon Network and Nickelodeon. A total of 290 Web pages and 247 unique games on 19 Internet sites were examined.ResultsGames, found on 81% of Web sites, were the most predominant promotion strategy used. All games had at least 1 brand identifier, with logos being most frequently used. On average Web sites contained 1 “healthful” message for every 45 exposures to brand identifiers.Conclusions and ImplicationsFood companies use Web sites to extend their television advertising to promote brand loyalty among children. These sites almost exclusively promoted food items high in sugar and fat. Health professionals need to monitor food industry marketing practices used in “new media.”     

Social media: How hospital facebook activity may influence patient satisfaction

Abstract

Some hospitals use social media to promote accurate health-related education, information, and engage consumers. We performed multiple linear regression analyses to determine the associations between hospital Facebook activity and patient satisfaction for 390 hospitals. Hospitals that had a Facebook page were active on Facebook in the past 30?days and had more “likes,” had more patients willing to definitely recommend the hospital, and had a higher overall satisfaction score. Practitioners can use the results when considering whether a minimal financial investment in social media may be worth customer loyalty and Centers for Medicare and Medicaid Systems (CMS) reimbursement benefits.     

Social media networking: Facebook and Twitter

The new wave of marketing and practice promotion will include social media networking. This article will discuss Facebook and Twitter. After reading this article you, will have an understanding of these two important aspects of social media and how you might use Facebook and Twitter in your practice to enhance your communication with your existing patients and attract new patients.     

Facebook network structure and awareness of preexposure prophylaxis among young men who have sex with men

BackgroundYoung Black men who have sex with men (YBMSM) are the only population in the United States who have experienced rising human immunodeficiency virus incidence over the past decade. Consistent pre-exposure prophylaxis (PrEP) use can substantially reduce the risk of human immunodeficiency virus acquisition. What differentiates those who become aware of PrEP, and those who do not, remains largely unknown.MethodsThe social networks of YBMSM can impact their awareness of PrEP; to examine this impact, we used two waves of Facebook data from “uConnect”–a longitudinal cohort study of YBMSM in Chicago (n = 266).ResultsWhile PrEP awareness increased from 45% at baseline to 75% at follow-up, its use remained low (4% and 6%). There were 88 PrEP-unaware individuals at baseline who became aware (BA) by follow-up, and 56 who remained persistently unaware. While the persistently unawares had a higher median number of total Facebook friends, the BAs had a higher median numbers of friends who participated in uConnect, who were PrEP-aware, and who practiced behaviors previously found to be associated with individual-level awareness of PrEP at baseline. The BAs also had substantially more “influential” friends.ConclusionThese findings demonstrate the potential of social networks in raising PrEP awareness and use among YBMSM.