Groupe de recherche en épidémiologie des zoonoses et santé publique, Université de Montréal, Saint-Hyacinthe, QC, Canada.
Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada.
J Med Internet Res. 2024 Aug 13;26:e51325. doi: 10.2196/51325.
The effectiveness of public health measures (PHMs) depends on population adherence. Social media were suggested as a tool to assess adherence, but representativeness and accuracy issues have been raised.
The objectives of this repeated cross-sectional study were to compare self-reported PHM adherence and sociodemographic characteristics between people who used Twitter (subsequently rebranded X) and people who did not use Twitter.
Repeated Canada-wide web-based surveys were conducted every 14 days from September 2020 to March 2022. Weighted proportions were calculated for descriptive variables. Using Bayesian logistic regression models, we investigated associations between Twitter use, as well as opinions in tweets, and self-reported adherence with mask wearing and vaccination.
Data from 40,230 respondents were analyzed. As self-reported, Twitter was used by 20.6% (95% CI 20.1%-21.2%) of Canadians, of whom 29.9% (95% CI 28.6%-31.3%) tweeted about COVID-19. The sociodemographic characteristics differed across categories of Twitter use and opinions. Overall, 11% (95% CI 10.6%-11.3%) of Canadians reported poor adherence to mask-wearing, and 10.8% (95% CI 10.4%-11.2%) to vaccination. Twitter users who tweeted about COVID-19 reported poorer adherence to mask wearing than nonusers, which was modified by the age of the respondents and their geographical region (odds ratio [OR] 0.79, 95% Bayesian credibility interval [BCI] 0.18-1.69 to OR 4.83, 95% BCI 3.13-6.86). The odds of poor adherence to vaccination of Twitter users who tweeted about COVID-19 were greater than those of nonusers (OR 1.76, 95% BCI 1.48-2.07). English- and French-speaking Twitter users who tweeted critically of PHMs were more likely (OR 4.07, 95% BCI 3.38-4.80 and OR 7.31, 95% BCI 4.26-11.03, respectively) to report poor adherence to mask wearing than non-Twitter users, and those who tweeted in support were less likely (OR 0.47, 95% BCI 0.31-0.64 and OR 0.96, 95% BCI 0.18-2.33, respectively) to report poor adherence to mask wearing than non-Twitter users. The OR of poor adherence to vaccination for those tweeting critically about PHMs and for those tweeting in support of PHMs were 4.10 (95% BCI 3.40-4.85) and 0.20 (95% BCI 0.10-0.32), respectively, compared to non-Twitter users.
Opinions shared on Twitter can be useful to public health authorities, as they are associated with adherence to PHMs. However, the sociodemographics of social media users do not represent the general population, calling for caution when using tweets to assess general population-level behaviors.
公共卫生措施（PHM）的有效性取决于人口的依从性。有人提出，社交媒体可以作为评估依从性的一种工具，但也存在代表性和准确性问题。
本重复横断面研究的目的是比较使用 Twitter（后更名为 X）和不使用 Twitter 的人群在自我报告的 PHM 依从性和社会人口统计学特征方面的差异。
从 2020 年 9 月至 2022 年 3 月，每隔 14 天进行一次加拿大范围内的在线重复调查。计算描述性变量的加权比例。使用贝叶斯逻辑回归模型，我们调查了 Twitter 使用情况以及推文观点与自我报告的戴口罩和接种疫苗依从性之间的关联。
对 40230 名受访者的数据进行了分析。自我报告显示，20.6%（95%置信区间 20.1%-21.2%）的加拿大人使用 Twitter，其中 29.9%（95%置信区间 28.6%-31.3%）的人在 Twitter 上发布了有关 COVID-19 的信息。Twitter 的使用情况和观点因类别而异，社会人口统计学特征也存在差异。总体而言，11%（95%置信区间 10.6%-11.3%）的加拿大人报告口罩佩戴依从性差，10.8%（95%置信区间 10.4%-11.2%）的人报告疫苗接种依从性差。与非用户相比，发布有关 COVID-19 推文的 Twitter 用户报告的口罩佩戴依从性较差，这种差异受受访者年龄和所在地区的影响（比值比[OR]0.79，95%贝叶斯可信度区间[BCI]0.18-1.69至 OR 4.83，95% BCI 3.13-6.86）。发布有关 COVID-19 推文的 Twitter 用户接种疫苗依从性差的可能性大于非用户（OR 1.76，95% BCI 1.48-2.07）。批评 PHM 的英语和法语 Twitter 用户（OR 4.07，95% BCI 3.38-4.80 和 OR 7.31，95% BCI 4.26-11.03）比非 Twitter 用户更有可能报告口罩佩戴依从性差，而支持 PHM 的推文用户则不太可能报告口罩佩戴依从性差（OR 0.47，95% BCI 0.31-0.64 和 OR 0.96，95% BCI 0.18-2.33）。对于那些批评 PHM 的推文用户和支持 PHM 的推文用户，接种疫苗依从性差的 OR 分别为 4.10（95% BCI 3.40-4.85）和 0.20（95% BCI 0.10-0.32），而非 Twitter 用户。
在 Twitter 上分享的观点可以为公共卫生当局提供有用的信息，因为它们与 PHM 的依从性相关。然而，社交媒体用户的社会人口统计学特征并不代表一般人群，因此在使用推文来评估一般人群的行为时需要谨慎。
