Lenoir Philippe, Moulahi Bilel, Azé Jérôme, Bringay Sandra, Mercier Gregoire, Carbonnel François
Department of General Practice, Montpellier University, Montpellier, France.
Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier, UMR 5506, Montpellier University/Centre National de la Recherche Scientifique, Montpellier, France.
J Med Internet Res. 2017 Oct 16;19(10):e344. doi: 10.2196/jmir.8421.
Cervical cancer is the second most common cancer among women under 45 years of age. To deal with the decrease of smear test coverage in the United Kingdom, a Twitter campaign called #SmearForSmear has been launched in 2015 for the European Cervical Cancer Prevention Week. Its aim was to encourage women to take a selfie showing their lipstick going over the edge and post it on Twitter with a raising awareness message promoting cervical cancer screening. The estimated audience was 500 million people. Other public health campaigns have been launched on social media such as Movember to encourage participation and self-engagement. Their result was unsatisfactory as their aim had been diluted to become mainly a social buzz.
The objectives of this study were to identify the tweets delivering a raising awareness message promoting cervical cancer screening (sensitizing tweets) and to understand the characteristics of Twitter users posting about this campaign.
We conducted a 3-step content analysis of the English tweets tagged #SmearForSmear posted on Twitter for the 2015 European Cervical Cancer Prevention Week. Data were collected using the Twitter application programming interface. Their extraction was based on an analysis grid generated by 2 independent researchers using a thematic analysis, validated by a strong Cohen kappa coefficient. A total of 7 themes were coded for sensitizing tweets and 14 for Twitter users' status. Verbatims were thematically and then statistically analyzed.
A total of 3019 tweets were collected and 1881 were analyzed. Moreover, 69.96% of tweets had been posted by people living in the United Kingdom. A total of 57.36% of users were women, and sex was unknown in 35.99% of cases. In addition, 54.44% of the users had posted at least one selfie with smeared lipstick. Furthermore, 32.32% of tweets were sensitizing. Independent factors associated with posting sensitizing tweets were women who experienced an abnormal smear test (OR [odds ratio] 13.456, 95% CI 3.101-58.378, P<.001), female gender (OR 3.752, 95% CI 2.133-6.598, P<.001), and people who live in the United Kingdom (OR 2.097, 95% CI 1.447-3.038, P<.001). Nonsensitizing tweets were statistically more posted by a nonhealth or nonmedia company (OR 0.558, 95% CI 0.383-0.814, P<.001).
This study demonstrates that the success of a public health campaign using a social media platform depends on its ability to get its targets involved. It also suggests the need to use social marketing to help its dissemination. The clinical impact of this Twitter campaign to increase cervical cancer screening is yet to be evaluated.
宫颈癌是45岁以下女性中第二常见的癌症。为应对英国宫颈涂片检查覆盖率下降的情况，2015年欧洲宫颈癌预防周期间发起了一项名为#SmearForSmear的推特活动。其目的是鼓励女性自拍，展示口红涂抹到边缘的样子，并在推特上发布一条提高对宫颈癌筛查认识的信息。估计受众达5亿人。其他公共卫生活动也已在社交媒体上开展，如“胡须月”活动，以鼓励参与和自我投入。但这些活动的效果并不理想，因为其目标已被淡化，主要变成了一种社交热潮。
本研究的目的是识别传递提高宫颈癌筛查认识信息的推文（宣传推文），并了解发布该活动相关内容的推特用户的特征。
我们对2015年欧洲宫颈癌预防周期间在推特上发布的带有#SmearForSmear标签的英文推文进行了三步内容分析。数据通过推特应用程序编程接口收集。其提取基于由两名独立研究人员使用主题分析生成的分析网格，并通过强科恩kappa系数进行验证。总共为宣传推文编码了7个主题，为推特用户状态编码了14个主题。对逐字记录进行了主题分析，然后进行统计分析。
共收集到3019条推文，其中1881条进行了分析。此外，69.96%的推文由居住在英国的人发布。共有57.36%的用户为女性，35.99%的情况性别未知。此外，54.44%的用户至少发布了一张涂抹口红的自拍。此外，32.32%的推文具有宣传性质。与发布宣传推文相关联的独立因素包括经历过异常宫颈涂片检查的女性（比值比[OR]13.456，95%置信区间3.101 - 58.378，P <.001）、女性性别（OR 3.752，95%置信区间2.133 - 6.598，P <.001）以及居住在英国的人（OR 2.097，95%置信区间1.447 - 3.038，P <.001）。非宣传推文在统计学上更多地由非健康或非媒体公司发布（OR 0.558，95%置信区间0.383 - 0.814，P <.001）。
本研究表明，利用社交媒体平台开展的公共卫生活动的成功取决于其让目标人群参与的能力。这也表明需要运用社会营销来促进其传播。这项推特活动对增加宫颈癌筛查的临床影响还有待评估。
