Yvonne M. Hunt

Social Media Use in the United States: Implications for Health Communication

Background Given the rapid changes in the communication landscape brought about by participative Internet use and social media, it is important to develop a better understanding of these technologies and their impact on health communication. The first step in this effort is to identify the characteristics of current social media users. Up-to-date reporting of current social media use will help monitor the growth of social media and inform health promotion/communication efforts aiming to effectively utilize social media. Objective The purpose of the study is to identify the sociodemographic and health-related factors associated with current adult social media users in the United States. Methods Data came from the 2007 iteration of the Health Information National Trends Study (HINTS, N = 7674). HINTS is a nationally representative cross-sectional survey on health-related communication trends and practices. Survey respondents who reported having accessed the Internet (N = 5078) were asked whether, over the past year, they had (1) participated in an online support group, (2) written in a blog, (3) visited a social networking site. Bivariate and multivariate logistic regression analyses were conducted to identify predictors of each type of social media use. Results Approximately 69% of US adults reported having access to the Internet in 2007. Among Internet users, 5% participated in an online support group, 7% reported blogging, and 23% used a social networking site. Multivariate analysis found that younger age was the only significant predictor of blogging and social networking site participation; a statistically significant linear relationship was observed, with younger categories reporting more frequent use. Younger age, poorer subjective health, and a personal cancer experience predicted support group participation. In general, social media are penetrating the US population independent of education, race/ethnicity, or health care access. Conclusions Recent growth of social media is not uniformly distributed across age groups; therefore, health communication programs utilizing social media must first consider the age of the targeted population to help ensure that messages reach the intended audience. While racial/ethnic and health status–related disparities exist in Internet access, among those with Internet access, these characteristics do not affect social media use. This finding suggests that the new technologies, represented by social media, may be changing the communication pattern throughout the United States.

Cancer Survivorship in the Age of YouTube and Social Media: A Narrative Analysis

Background As evidenced by the increasing popularity of YouTube (www.youtube.com), personal narratives shared through social media are an area of rapid development in communication among cancer survivors. Identifying the thematic and linguistic characteristics of YouTube cancer stories can provide a better understanding of this naturally occurring communication channel and inform social media communication efforts aiming to use personal stories to reach individuals with serious illnesses. Objective The objective of our study was to provide an in-depth description of authentic personal cancer stories. Through a linguistically based narrative analysis of YouTube stories, the analysis explicates the common attributes of these narratives. Methods Informed by narrative theories, we conducted an iterative, bottom-up analysis of 35 YouTube videos identified by the search terms “cancer survivor” and “cancer stories”. A list of shared thematic and linguistic characteristics was identified and analyzed. Results A subnarrative on the cancer diagnosis was present in 86% (30/35) of the stories under analysis. These diagnostic narratives were characterized by dramatic tension, emotional engagement, markers of the loss of agency or control, depersonalized reference to the medical personnel, and the unexpectedness of a cancer diagnosis. The analysis highlights the themes of story authenticity and emotional engagement in this online communication medium. Conclusions Internet advances have enabled new and efficient exchange of personal stories, including the sharing of personal cancer experience among cancer survivors and their caregivers. The analytic results of this descriptive study point to the common characteristics of authentic cancer survivorship stories online. Furthermore, the results of this descriptive study may inform development of narrative-based communication, particularly in maintaining authenticity and emotional engagement.

History and Culture of Tanning in the United States

This chapter traces changes in the perception of tanning and tanning behavior primarily within the United States (U.S.) from the later part of the nineteenth century to the early part of the twenty-first century. Originally seen as a hallmark of the working class/disadvantaged groups and associated with disease and ill health, societal perceptions of the tan evolved over time to reflect the opposite: wealth, health and beauty. These core beliefs regarding the value of tanning and ultraviolet (UV) radiation exposure have proven extremely difficult to modify despite substantial efforts by the public health community to do so. In an attempt to understand why millions of Americans continue to engage in high-risk, intentional UV exposure such as use of indoor tanning facilities, the beliefs and behaviors related to tanning are considered within the context of the historical medical and societal factors, especially the role of fashion and advertising, which helped to shape current opinion.

Smoking Cessation in Recovery: Comparing 2 Different Cognitive Behavioral Treatments

ObjectivesThe purpose of this pilot demonstration study was to evaluate the feasibility and effectiveness of adding a contingency management (CM) component to the standard cognitive-behavioral smoking cessation treatment offered to veterans in a residential substance-abuse treatment program. Specifically, we assessed the impact of CM on (1) engagement in smoking cessation treatment, (2) retention in smoking cessation treatment, and (3) abstinence from smoking. MethodsParticipants were 65 male veterans in inpatient treatment for a primary substance use disorder who expressed interest in quitting smoking. Participants were enrolled in either the standard or CM smoking cessation treatment program. All participants were offered 4 sessions of cognitive-behavioral group counseling; participants in the CM program also had the opportunity to earn cash vouchers for session attendance and abstinence from smoking. ResultsThe CM treatment program showed superior treatment engagement and retention rates. Survival analysis showed that 58% of participants receiving the CM treatment were smoke-free on quit day, versus only 17% of participants in standard care. In addition, the end of treatment continuous abstinence rate was significantly higher in the CM condition compared with standard care (21% vs. 0%). ConclusionsThese preliminary results suggest that contingency management approaches may be useful for maximizing participation in smoking cessation treatment and improving treatment outcomes among recovering substance users.

If you build (and moderate) it, they will come: the Smokefree Women Facebook page.

This analysis explores the impact of modifying the Smokefree Women Facebook social media strategy, from primarily promoting resources to encouraging participation in communications about smoking cessation by posting user-generated content. Analyses were performed using data from the Smokefree Women Facebook page to assess the impact of the revised strategy on reach and engagement. Fan engagement increased 430%, and a strong and statistically significant correlation (P < .05) between the frequency of moderator posts and community engagement was observed. The reach of the page also increased by 420%. Our findings indicate that the strategy shift had a statistically significant and positive effect on the frequency of interactions on the Facebook page, providing an example of an approach that may prove useful for reaching and engaging users in online communities. Additional research is needed to assess the association between engagement in virtual communities and health behavior outcomes.

Analysing user-reported data for enhancement of SmokefreeTXT: a national text message smoking cessation intervention

Objective This observational study highlights key insights related to participant engagement and cessation among adults who voluntarily subscribed to the nationwide US-based SmokefreeTXT program, a 42-day mobile phone text message smoking cessation program. Methods Point prevalence abstinence rates were calculated for subscribers who initiated treatment in the program (n=18 080). The primary outcomes for this study were treatment completion and point prevalence abstinence rate at the end of the 42-day treatment. Secondary outcomes were point prevalence abstinence rates at 7 days postquit, 3 months post-treatment and 6 months post-treatment, as well as response rates to point prevalence abstinence assessments. Results Over half the sample completed the 42-day treatment (n=9686). The end-of-treatment point prevalence abstinence for subscribers who initiated treatment was 7.2%. Among those who completed the entire 42 days of treatment, the end-of-treatment point prevalence abstinence was 12.9%. For subscribers who completed treatment, point prevalence abstinence results varied: 7 days postquit (23.7%), 3 months post-treatment (7.3%) and 6 months post-treatment (3.7%). Response rates for abstinence assessment messages ranged from 4.36% to 34.48%. Conclusions Findings from this study illuminate the need to more deeply understand reasons for subscriber non-response and opt out and, in turn, improve program engagement and our ability to increase the likelihood for participants to stop smoking and measure long-term outcomes. Patterns of opt out for the program mirror the relapse curve generally observed for smoking cessation, thus highlighting time points at which to increase efforts to retain participants and provide additional support or incentives.

Sequential Treatment for Nicotine Dependence and Postcessation Weight Concern in a Female Diagnosed with Paranoid Schizophrenia

Despite declines in smoking prevalence, some populations represent significant challenges to tobacco cessation programs, including smokers with psychiatric comorbidity and/or weight concerns. Few studies have found effective interventions for tobacco cessation or addressed the prevalence of smoking-related concerns in psychiatric populations. The side effects of many psychotropic medications, decreased participation in physical activity, and weight gain following cessation suggest that postcessation weight concerns and actual weight gain may be significant barriers to cessation as well. Therefore, serial interventions, rather than simultaneous ones, seem well suited to address these issues. This case study represents the piloting of serial cessation and postcessation weight gain prevention interventions in a female diagnosed with paranoid schizophrenia. Results suggested that the serial implementation of cognitive-behavioral interventions can be effective in promoting tobacco cessation in individuals with co-occurring disorders.

Using a Media Campaign to Increase Engagement With a Mobile-Based Youth Smoking Cessation Program:

Purpose: To describe the impact of the National Cancer Institute’s promotion of its youth smoking cessation program, Smokefree Teen (SFT). Design: We provide a description of campaign strategies and outcomes as a means to engage a teen audience in cessation resources using a cost-effective approach. Setting: The campaign occurred nationally, using traditional (TV and radio), online, and social media outreach. Participants: Ads targeted adolescent smokers (aged 14-17). The baseline population was 42 586 and increased to 464 357 during the campaign. Measures: Metrics used to assess outcomes include (1) visits to SFT website from traditional and online ads, (2) cost to get an online ad clicked (cost-per-click), and (3) SmokefreeTXT program enrollments during the 8-week campaign period. Analysis: We conducted a quantitative performance review of all tactics. Results: The SFT campaign achieved an online ad click-through rate of 0.33%, exceeding industry averages of 0.15%. Overall, web traffic to teen.smokefree.gov increased by 980%, and the online cost-per-click for ads, including social media actions, was approximately

Assessing a smoking cessation intervention for veterans in substance use disorder treatment

1 as compared with

Descriptive characteristics and cluster analysis of male veteran hazardous drinkers in an alcohol moderation intervention.

107 for traditional ads. Additionally, the campaign increased the SmokefreeTXT program teen sign-ups by 1334%. Conclusion: The campaign increased engagement with evidence-informed cessation resources for teen smokers. Results show the potential of using multiple, online channels to help increase engagement with core resources.