Department of Communication Studies, School of Communication, Hong Kong Baptist University, Hong Kong, Hong Kong.
Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
JMIR Mhealth Uhealth. 2021 Mar 1;9(3):e19239. doi: 10.2196/19239.
There has been a significant increase in the trend of using social media as a platform to deliver weight management interventions. This illustrates a need to develop a holistic understanding of doctor-patient communication and peer-to-peer communication in social media interventions and to determine their influences on weight management for people with overweight or obesity. Such studies will highlight how social media can be more effectively integrated into weight management programs to enhance individuals' short-term and long-term weight management behaviors.
The aim of this study was to examine patients' experiences with doctor-patient communication and peer interactions in a social media-based (WeChat) weight management program, and to describe the interplay of three social influence factors-social support, social comparison, and surveillance-in their weight control practices. The program, designed and implemented by the research team located in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components that targeted people with overweight or obesity.
We conducted in-depth interviews with 32 program participants of different ages (mean 35.6, SD 7.7 years), gender (18 women), duration of program membership (mean 1.4 years), and weight loss outcomes (54% weight loss to 9% weight gain). All interview data were audio-recorded, transcribed, and translated using the translation-backtranslation technique. Nvivo software was used to facilitate the coding process.
Results of thematic analysis indicated the distinct functions of professionally led support and peer support. Professional support was presented in the form of knowledge infusion, efficacy enhancement, and provision of timely feedback. Peer support fostered empathy and sense of belonging, and had a mutually reinforcing relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it also reinforced negative group norms, and resulted in downturns in reference standards and collective inactivity. Social media surveillance prompted participants' reactions to the gaze from medical professionals and peers that could be encouraging or inhibiting. Surveillance enhanced vigilance with weight control norms; however, its influence weakened when participants chose to fake weight data and turn off notifications. Findings from this study illustrated the interrelated and fluctuating influences of support, comparison, and surveillance.
The interactive traits of social media eased the practices of social support and social comparison, and created new forms of surveillance. This study contributes to an in-depth understanding of social media influences on individuals' weight control behaviors. Practical implications of the study concern improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology.
Chinese Clinical Trial Registry ChiCTR1900025861; http://www.chictr.org.cn/showprojen.aspx?proj=42497.
社交媒体作为一种提供体重管理干预的平台，其使用趋势显著增加。这表明需要全面了解社交媒体干预措施中的医患沟通和同伴间沟通，并确定它们对超重或肥胖人群体重管理的影响。此类研究将突出展示如何更有效地将社交媒体整合到体重管理计划中，以增强个人的短期和长期体重管理行为。
本研究旨在考察患者在基于社交媒体（微信）的体重管理计划中对医患沟通和同伴互动的体验，并描述三种社会影响因素（社会支持、社会比较和监督）在其体重控制实践中的相互作用。该计划由中国东南部一家三级转诊医院的研究团队设计和实施，包括饮食和身体活动两部分，针对超重或肥胖人群。
我们对 32 名不同年龄（平均 35.6 岁，标准差 7.7 岁）、性别（18 名女性）、计划参与时间（平均 1.4 年）和减肥效果（体重减轻 54%至体重增加 9%）的计划参与者进行了深入访谈。所有访谈数据均使用翻译-回译技术进行录音、转录和翻译。使用 Nvivo 软件辅助编码过程。
主题分析结果表明，专业主导支持和同伴支持具有不同的功能。专业支持表现为知识灌输、增强效能和提供及时反馈。同伴支持培养了同理心和归属感，并与同伴比较和基于同伴的监督形成了相互增强的关系。同伴比较增强了动力和积极竞争。然而，它也强化了负面的群体规范，并导致参考标准下降和集体不作为。社交媒体监督促使参与者对医疗专业人员和同伴的关注做出反应，这些反应可能是鼓励性的，也可能是抑制性的。监督增强了对体重控制规范的警惕性；然而，当参与者选择伪造体重数据并关闭通知时，其影响会减弱。本研究的结果说明了支持、比较和监督的相互关联和波动的影响。
社交媒体的互动特性简化了社会支持和社会比较的实践，并创造了新的监督形式。本研究有助于深入了解社交媒体对个人体重控制行为的影响。研究的实际意义在于改善维持社交媒体互动积极动态和防止对监督技术产生负面抵制的策略。
中国临床试验注册中心 ChiCTR1900025861；http://www.chictr.org.cn/showprojen.aspx?proj=42497。
