Gough Aisling, Hunter Ruth F, Ajao Oluwaseun, Jurek Anna, McKeown Gary, Hong Jun, Barrett Eimear, Ferguson Marbeth, McElwee Gerry, McCarthy Miriam, Kee Frank
UKCRC Centre of Excellence in Public Health Northern Ireland, School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
UKCRC Centre of Excellence in Public Health Northern Ireland, School of Medicine, Dentistry & Biological Sciences, Queen's University Belfast, Belfast, United Kingdom.
JMIR Public Health Surveill. 2017 Mar 23;3(1):e14. doi: 10.2196/publichealth.6313.
Social media public health campaigns have the advantage of tailored messaging at low cost and large reach, but little is known about what would determine their feasibility as tools for inducing attitude and behavior change.
The aim of this study was to test the feasibility of designing, implementing, and evaluating a social media-enabled intervention for skin cancer prevention.
A quasi-experimental feasibility study used social media (Twitter) to disseminate different message "frames" related to care in the sun and cancer prevention. Phase 1 utilized the Northern Ireland cancer charity's Twitter platform (May 1 to July 14, 2015). Following a 2-week "washout" period, Phase 2 commenced (August 1 to September 30, 2015) using a bespoke Twitter platform. Phase 2 also included a Thunderclap, whereby users allowed their social media accounts to automatically post a bespoke message on their behalf. Message frames were categorized into 5 broad categories: humor, shock or disgust, informative, personal stories, and opportunistic. Seed users with a notable following were contacted to be "influencers" in retweeting campaign content. A pre- and postintervention Web-based survey recorded skin cancer prevention knowledge and attitudes in Northern Ireland (population 1.8 million).
There were a total of 417,678 tweet impressions, 11,213 engagements, and 1211 retweets related to our campaign. Shocking messages generated the greatest impressions (shock, n=2369; informative, n=2258; humorous, n=1458; story, n=1680), whereas humorous messages generated greater engagement (humorous, n=148; shock, n=147; story, n=117; informative, n=100) and greater engagement rates compared with story tweets. Informative messages, resulted in the greatest number of shares (informative, n=17; humorous, n=10; shock, n=9; story, n=7). The study findings included improved knowledge of skin cancer severity in a pre- and postintervention Web-based survey, with greater awareness that skin cancer is the most common form of cancer (preintervention: 28.4% [95/335] vs postintervention: 39.3% [168/428] answered "True") and that melanoma is most serious (49.1% [165/336] vs 55.5% [238/429]). The results also show improved attitudes toward ultraviolet (UV) exposure and skin cancer with a reduction in agreement that respondents "like to tan" (60.5% [202/334] vs 55.6% [238/428]).
Social media-disseminated public health messages reached more than 23% of the Northern Ireland population. A Web-based survey suggested that the campaign might have contributed to improved knowledge and attitudes toward skin cancer among the target population. Findings suggested that shocking and humorous messages generated greatest impressions and engagement, but information-based messages were likely to be shared most. The extent of behavioral change as a result of the campaign remains to be explored, however, the change of attitudes and knowledge is promising. Social media is an inexpensive, effective method for delivering public health messages. However, existing and traditional process evaluation methods may not be suitable for social media.
社交媒体公共卫生运动具有以低成本广泛传播定制信息的优势，但对于决定其作为诱导态度和行为改变工具的可行性因素知之甚少。
本研究旨在测试设计、实施和评估一项利用社交媒体预防皮肤癌干预措施的可行性。
一项准实验性可行性研究利用社交媒体（推特）传播与阳光下护理和癌症预防相关的不同信息“框架”。第一阶段利用北爱尔兰癌症慈善机构的推特平台（2015年5月1日至7月14日）。经过为期2周的“洗脱期”后，第二阶段（2015年8月1日至9月30日）使用定制的推特平台展开。第二阶段还包括一次“闪电行动”，即用户允许其社交媒体账户代表他们自动发布一条定制信息。信息框架分为5大类：幽默类、震惊或厌恶类、信息类、个人故事类和机会主义类。联系了拥有大量关注者的种子用户，让他们成为转发活动内容的“影响者”。一项干预前后基于网络的调查记录了北爱尔兰（人口180万）的皮肤癌预防知识和态度。
与我们的活动相关的推文总展示量为417,678次，参与度为11,213次，转发量为1211次。令人震惊的信息产生的展示量最大（震惊类，n = 2369；信息类，n = 2258；幽默类，n = 1458；故事类，n = 1680），而幽默类信息产生的参与度更高（幽默类，n = 148；震惊类，n = 147；故事类，n = 117；信息类，n = 100），与故事类推文相比参与率也更高。信息类信息的分享量最多（信息类，n = 17；幽默类，n = 10；震惊类，n = 9；故事类，n = 7）。研究结果包括在干预前后基于网络的调查中，对皮肤癌严重程度的认识有所提高，更多人意识到皮肤癌是最常见的癌症形式（干预前：28.4% [95/335]，干预后：39.3% [168/428]回答“是”），以及黑色素瘤最为严重（49.1% [165/336]，干预后：55.5% [238/429]）。结果还显示，对紫外线暴露和皮肤癌的态度有所改善，同意“喜欢晒黑”的受访者比例有所下降（60.5% [202/334]，干预后：55.6% [238/428]）。
社交媒体传播的公共卫生信息覆盖了北爱尔兰超过23%的人口。一项基于网络的调查表明，该活动可能有助于提高目标人群对皮肤癌的认识和态度。研究结果表明，令人震惊和幽默的信息产生的展示量和参与度最大，但基于信息的信息可能分享得最多。然而，该活动导致的行为改变程度仍有待探索，但态度和知识的改变很有希望。社交媒体是一种提供公共卫生信息的低成本、有效方法。然而，现有的传统过程评估方法可能不适用于社交媒体
