Effective uses of social media in healthcare: a living systematic review of reviews

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Contents

Introduction

See also Blogs | Facebook | Twitter | Systematic reviews

In August 2017, we (Giustini, Ali, Fraser and Boulos) completed our systematic review of systematic reviews on the effective uses of social media in healthcare. It was a massive project. The paper is a systematic, qualitative synthesis of the literature. In 2016, we registered our protocol at PROSPERO. We conducted highly-sensitive searches in several academic and biomedical databases up to and including December 2016. We found 8521 papers in fifteen bibliographic databases and web search engines. Deduplication and screening reduced the number to 102 which were critically-appraised. Forty-two papers scored high (9 or 10) using the CASP instrument.

The authors of this systematic review now propose to make it a ‘living systematic review’ through the use of this wiki where future updates to our review will be posted, including new/future papers satisfying our inclusion criteria, and a brief thematic categorization of papers (in a table following the same format used in our SR). As the information retrieval expert on the team, I have re-run our searches: more than 200 papers have been published since January 2017. However, a quick title and abstract screening reveal about a 15% inclusion rate. Readers of this SR are encouraged to visit from time to time to chart this fast-moving domain for the future (beyond the 42 papers we included in our review). However, successive versions of this review in the future can be seen as an ongoing limitation, since we are pooling studies that looked at different versions of SM over time.

Keywords

Forty-seven (47) possible new papers late 2016 to 2017 -

[An R, Ji M, Zhang S. Effectiveness of Social Media-based Interventions on Weight-related Behaviors and Body Weight Status: Review and Meta-analysis. American Journal of Health Behavior. 41(6):670-682, 2017 Nov 01.]

OBJECTIVES: We reviewed scientific literature regarding the effectiveness of social media-based interventions about weight-related behaviors and body weight status.
METHODS: A keyword search were performed in May 2017 in the Clinical-Trials.gov, Cochrane Library, PsycINFO, PubMed, and Web of Science databases. We conducted a meta-analysis to estimate the pooled effect size of social media-based interventions on weight-related outcome measures.
RESULTS: We identified 22 interventions from the keyword and reference search, including 12 randomized controlled trials, 6 pre-post studies and 3 cohort studies conducted in 9 countries during 2010-2016. The majority (N = 17) used Facebook, followed by Twitter (N = 4) and Instagram (N = 1). Intervention durations averaged 17.8 weeks with a mean sample size of 69. The meta-analysis showed that social media-based interventions were associated with a statistically significant, but clinically modest reduction of body weight by 1.01 kg, body mass index by 0.92 kg/m2, and waist circumstance by 2.65 cm, and an increase of daily number of steps taken by 1530. In the meta-regression there was no doseresponse effect with respect to intervention duration.
CONCLUSIONS: The boom of social media provides an unprecedented opportunity to implement health promotion programs. Future interventions should make efforts to improve intervention scalability and effectiveness.

Asiri H, Househ M. The Impact of Twitter and Facebook on Nursing Practice and Education: A Systematic Review of the Literature. Studies In Health Technology & Informatics. 2016;226:267-70. Unique topic.PNG

This systematic review aims to answer the following question: What is the impact of Twitter and Facebook on nursing practice and education? Any article that was written in English and was published in PubMed and Computers Informatics Nursing (CIN) journal from 2011 up to 2016 and discussed the impact of Twitter and Facebook on nursing practice and education was included, while any opinion and review articles were excluded. The results show three themes that are covered by the literature: (1) using social media to enhance students’ confidence and /or self-efficacy, (2) characteristics of nurses who use social media, and (3) preferred modes of communication. Further research is still needed to reveal the impact of Twitter and Facebook on nursing education as well as other specialties of nursing practice.

What this adds to our SR

  • This is one of the few SRs focussed on how nurses are using SM in their practice and education. The search was not extensive (n=2 only PubMed and one journal handsearched). Only 4 studies were included in the analysis. Results showed that it is not clear what SM's impact is on nursing education and practice globally. The ethical use of SM was raised as a concern especially in communicating with patients.

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Baker DA, Algorta GP. The Relationship Between Online Social Networking and Depression: A Systematic Review of Quantitative Studies. Cyberpsychology, Behavior and Social Networking. 2016 01 Nov 2016;19(11):638-48.

Online social networking sites (SNSs) such as Facebook, Twitter, and MySpace are used by billions of people every day to communicate and interact with others. There has been increasing interest in the potential impact of online social networking on wellbeing, with a broadening body of new research into factors associated with both positive and negative mental health outcomes such as depression. This systematic review of empirical studies (n = 30) adds to existing research in this field by examining current quantitative studies focused on the relationship between online social networking and symptoms of depression. The academic databases PsycINFO, Web of Science, CINAHL, MEDLINE, and EMBASE were searched systematically using terms related to online social networking and depression. Reporting quality was critically appraised and the findings discussed with reference to their wider implications. The findings suggest that the relationship between online social networking and symptoms of depression may be complex and associated with multiple psychological, social, behavioral, and individual factors. Furthermore, the impact of online social networking on wellbeing may be both positive and negative, highlighting the need for future research to determine the impact of candidate mediators and moderators underlying these heterogeneous outcomes across evolving networks.

What this adds to our SR

  • This SR employed a search of 5 databases and included empirical studies (n = 30). The relationship between OSNs and symptoms of depression is complex and associated with multiple psychological, social, behavioral, and individual factors. OSNs introduce both positive and negative impacts; future research should aim to determine the impact of candidate mediators and moderators.

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Bilgrami Z, McLaughlin L, Milanaik R, Adesman A. Health implications of new-age technologies: a systematic review. Minerva Pediatr. 2017 Aug;69(4):348-367.

New-age technologies are ubiquitous in the lives of adolescents. Recent trends in media use suggest that adolescents are spending more time than ever engaging with technologies, and are able to do so in virtually all settings at any time. Given that new-age technologies are so heavily integrated within the daily life of adolescents, the health risks and benefits they offer must be closely examined. EVIDENCE ACQUISITION: In this systematic review, we present recent literature related to the implications of new-age technologies on adolescent health. A total of 94 articles published since 2006 were collected using PubMed and Google Scholar on the most popular new-age technologies among adolescents: the internet, television, cell phones, and video games. EVIDENCE SYNTHESIS: The current body of research highlights several health risks related to these technologies. Nearly all have the potential for addiction, which can result in other symptoms and impair one's daily life. Excessive use can affect several components of health, such as quality of sleep, body composition, and mental well-being, and certain practices (viewing pornography, sexting) can lead to risky sexual behaviors. However, the technologies discussed in the present review also have tremendous potential to promote adolescent health. CONCLUSIONS: Pediatricians must educate parents and patients on how to safely use technology to minimize the potentially harmful outcomes.

What this adds to our SR

  • This SR revealed SM's potential for addictive behaviours, and harmful outcomes, but it has tremendous potential in adolescent populations also. The search revealed a large body of evidence (n=94 papers). Fulltext could not be obtained.

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Bou-Karroum L, El-Jardali F, Hemadi N, Faraj Y, Ojha U, Shahrour M, Darzi A, Ali M, Doumit C, Langlois EV, Melki J, AbouHaidar GH, Akl EA. Using media to impact health policy-making: an integrative systematic review. Implement Sci. 2017 Apr 18;12(1):52.

INTRODUCTION: Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process. METHODS:Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. RESULTS: Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence.CONCLUSION: There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful.

What this adds to our SR

  • This well-conducted integrative systematic review identified n=10 eligible studies that evaluated the effects of planned media interventions on the different stages of health policy-making (except for policy evaluation). None of the evaluation studies assessed social media interventions. Better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful.

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Brown A., MacLure K., Stewart D., Addison B., Pedersen S. Healthcare regulatory organisation and professional body guidelines on the use of social media: A systematic review of e-professionalism. Netherlands: 23rd Health Services Research and Pharmacy Practice Conference, HSRPP 2017. United Kingdom. 25 (pp 33); Wiley-Blackwell Publishing Ltd; 2017

See http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016026877

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Choi EP, Wong JY, Fong DY. The use of social networking applications of smartphone and associated sexual risks in lesbian, gay, bisexual, and transgender populations: a systematic review. AIDS Care. 2017 Feb 1;29(2):145-55. Unique topic.PNG

The use of social networking applications (apps) on smartphones has the potential to impact sexual health and behaviour. This was the first systematic review to critically appraise and summarize the existing literature on the use of social networking apps on smartphones and their associated sexual health and sexual behaviour effects in lesbian, gay, bisexual and transgender populations. A systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. Studied outcomes included rates of unprotected sexual intercourse, the number of sexual partners, drug/alcohol use prior to/during sexual intercourse, sexually transmitted infections (STIs) testing and the prevalence of STIs. Among app users, the prevalence of unprotected sex ranged from 17.0% to 66.7%. The mean number of sexual partners ranged from 1.4 to 2.9 (last 1-month period), and from 46.2 to 79.6 (lifetime). Two studies found that the prevalence of HIV infection was 1.9% and 11.4%, respectively. The self-reported prevalence of prior diagnosis of STIs other than HIV ranged from 9.1% to 51.0%. It should be noted that the heterogeneity of the study design and outcome measures across different studies hindered the comparison of findings across different studies. Furthermore, the findings in some studies are not reliable due to methodological problems. Our results highlight the need for more research with rigorous methodology to understand the negative impacts of using these apps on sexual health and sexual behaviour. For future studies, the operational definition of outcomes, including social networking app use and unprotected anal intercourse (UAI), should be clearly outlined. The use of validated tools to measure sexual behaviour and biological measures of HIV and other STDs is preferable so that outcomes can be standardized to facilitate comparisons between studies and the pooling of data.

What this adds to our SR

  • Five databases were searched (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. This is the first SR that links apps, social networking activities among LGBTQ groups, and sexual risk behaviours. Problems with the studies included poor methodologies, lack of validated tools to measure behavioural differences, etc.

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Dorfman RG, Vaca EE, Fine NA, Schierle CF. The Ethics of Sharing Plastic Surgery Videos on Social Media: Systematic Literature Review, Ethical Analysis, and Proposed Guidelines. Plast Reconstr Surg. 2017 Oct;140(4):825-836. Unique topic.PNG

Recent videos shared by plastic surgeons on social media applications such as Snapchat, Instagram, and YouTube, among others, have blurred the line between entertainment and patient care. This has left many in the plastic surgery community calling for the development of more structured oversight and guidance regarding video sharing on social media. To date, no official guidelines exist for plastic surgeons to follow. Little is known about the ethical implications of social media use by plastic surgeons, especially with regard to video sharing. A systematic review of the literature on social media use in plastic surgery was performed on October 31, 2016, with an emphasis on ethics and professionalism. An ethical analysis was conducted using the four principles of medical ethics. The initial search yielded 87 articles. Thirty-four articles were included for analyses that were found to be relevant to the use of social media in plastic surgery. No peer-reviewed articles were found that mentioned Snapchat or addressed the ethical implications of sharing live videos of plastic surgery on social media. Using the four principles of medical ethics, it was determined that significant ethical concerns exist with broadcasting these videos. This analysis fills an important gap in the plastic surgery literature by addressing the ethical issues concerning live surgery broadcasts on social media. Plastic surgeons may use the guidelines proposed here to avoid potential pitfalls.

What this adds to our SR

This SR furthers the discussion of the ethics of innovative ("live surgery") social media usage by clinicians, particularly with respect to using SM for educational and professional purposes.

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Eckert S, Sopory P, Day A, Wilkins L, Padgett D, Novak J, Noyes J, Allen T, Alexander N, Vanderford M, Gamhewage G. Health-Related Disaster Communication and Social Media: Mixed-Method Systematic Review. Health Commun. 2017 Aug 21:1-12.

This mixed-method evidence synthesis drew on Cochrane methods and principles to systematically review literature published between 2003 and 2016 on the best social media practices to promote health protection and dispel misinformation during disasters. Seventy-nine studies employing quantitative, qualitative, and mixed methods on risk communication during disasters in all UN-languages were reviewed, finding that agencies need to contextualize the use of social media for particular populations and crises. Social media are tools that still have not become routine practices in many governmental agencies regarding public health in the countries studied. Social media, especially Twitter and Facebook (and equivalents in countries such as China), need to be incorporated into daily operations of governmental agencies and implementing partners to build familiarity with them before health-related crises happen. This was especially observed in US agencies, local government, and first responders but also for city governments and school administrations in Europe. For those that do use social media during health-related risk communication, studies find that public relations officers, governmental agencies, and the general public have used SM successfully to spread truthful information and to verify information to dispel rumors during disasters. Few studies focused on the recovery and preparation phases and on countries in the Southern hemisphere, except for Australia. The vast majority of studies did not analyze the demographics of social media users beyond their geographic location, their status of being inside/outside the disaster zone; and their frequency and content of posting. Socioeconomic demographics were not collected and/or analyzed to drill deeper into the implications of using social media to reach vulnerable populations. Who exactly is reached via social media campaigns and who needs to be reached with other means has remained an understudied area.

What this adds to our SR

  • 79 papers included; search was not explicit. SM is used in the US and Europe to disseminate information during disasters especially Facebook and Twitter, and their SM equivalents in places such as China. Some evidence suggesting SM can be useful but more needed to specify under what conditions, when and for whom.

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Fish JA, Peters MD, Ramsey I, Sharplin G, Corsini N, Eckert M. Effectiveness of public health messaging and communication channels during smoke events: A rapid systematic review. J Environm Management. 2017 May 15;193:247-56. Unique topic.PNG

Exposure to smoke emitted from wildfire and planned burns (i.e., smoke events) has been associated with numerous negative health outcomes, including respiratory symptoms and conditions. This rapid review investigates recent evidence (post-2009) regarding the effectiveness of public health messaging during smoke events. The objectives were to determine the effectiveness of various communication channels used and public health messages disseminated during smoke events, for general and at-risk populations. A search of 12 databases and grey literature yielded 1775 unique articles, of which 10 were included in this review. Principal results were: 1) Smoke-related public health messages are communicated via a variety of channels, but limited evidence is available regarding their effectiveness for the general public or at-risk groups. 2) Messages that use simple language are more commonly recalled, understood, and complied with. Compliance differs according to socio-demographic characteristics. 3) At-risk groups may be advised to stay indoors before the general population, in order to protect the most vulnerable people in a community. The research included in this review was observational and predominantly descriptive, and is therefore unable to sufficiently answer questions regarding effectiveness. Experimental research, as well as evaluations, are required to examine the effectiveness of modern communication channels, channels to reach at-risk groups, and the ‘stay indoors’ message.

What this adds to our SR

  • This unique review of n=10 papers provides an overview of the effectiveness of public health messaging using various communication channels during smoke events. A robust search of 12 databases and grey literature was conducted. A range of communication channels are used to issue public health messages to vulnerable populations during a smoke event, including mass media (television, radio, newspaper), face-to-face communication (with family, friends, neighbours, authorities, healthcare workers, and social networks), the internet, fact sheets, road signage, hotlines, school programs, and presentations at public events.

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Fung I, Duke C, Finch K, Snook K, Tseng P, Tse Z, et al. Ebola virus disease and social media: a systematic review. Am J Infection Control. 2016;44(12): 1660-1671. Unique topic.PNG

Objectives We systematically reviewed existing research pertinent to Ebola virus disease and social media, especially to identify the research questions and the methods used to collect and analyze social media. Methods We searched 6 databases for research articles pertinent to Ebola virus disease and social media. We extracted the data using a standardized form. We evaluated the quality of the included articles. Results Twelve articles were included in the main analysis: 7 from Twitter with 1 also including Weibo, 1 from Facebook, 3 from YouTube, and 1 from Instagram and Flickr. All the studies were cross-sectional. Eleven of the 12 articles studied ≥ 1of these 3 elements of social media and their relationships: themes or topics of social media contents, meta-data of social media posts (such as frequency of original posts and reposts, and impressions) and characteristics of the social media accounts that made these posts (such as whether they are individuals or institutions). One article studied how news videos influenced Twitter traffic. Twitter content analysis methods included text mining (n = 3) and manual coding (n = 1). Two studies involved mathematical modeling. All 3 YouTube studies and the Instagram/Flickr study used manual coding of videos and images, respectively. Conclusions Published Ebola virus disease-related social media research focused on Twitter and YouTube. The utility of social media research to public health practitioners is warranted.


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Ghosh D, Krishnan A, Gibson B, Brown SE, Latkin CA, Altice FL. Social Network Strategies to Address HIV Prevention and Treatment Continuum of Care Among At-risk and HIV-infected Substance Users: A Systematic Scoping Review. AIDS Behav. 2017 Apr;21(4):1183-1207.

Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.


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Gilchrist G, Swan D, Widyaratna K, Marquez-Arrico JE, Hughes E, Mdege ND, Martyn-St James M, Tirado-Munoz J. A Systematic Review and Meta-analysis of Psychosocial Interventions to Reduce Drug and Sexual Blood Borne Virus Risk Behaviours Among People Who Inject Drugs. AIDS and Behavior. 2017 Apr 1:1-21.

Opiate substitution treatment and needle exchanges have reduced blood borne virus (BBV) transmission among people who inject drugs (PWID). Psychosocial interventions could further prevent BBV. A systematic review and meta-analysis examined whether psychosocial interventions (e.g. CBT, skills training) compared to control interventions reduced BBV risk behaviours among PWID. 32 and 24 randomized control trials (2000-May 2015 in MEDLINE, PsycINFO, CINAHL, Cochrane Collaboration and Clinical trials, with an update in MEDLINE to December 2016) were included in the review and meta-analysis respectively. Psychosocial interventions appear to reduce: sharing of needles/syringes compared to education/information (SMD -0.52; 95% CI -1.02 to -0.03; I2 = 10%; p = 0.04) or HIV testing/counselling (SMD -0.24; 95% CI -0.44 to -0.03; I2 = 0%; p = 0.02); sharing of other injecting paraphernalia (SMD -0.24; 95% CI -0.42 to -0.06; I2 = 0%; p < 0.01) and unprotected sex (SMD -0.44; 95% CI -0.86 to -0.01; I2 = 79%; p = 0.04) compared to interventions of a lesser time/intensity, however, moderate to high heterogeneity was reported. Such interventions could be included with other harm reduction approaches to prevent BBV transmission among PWID.

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Golder S, Ahmed S, Norman G, Booth A. Attitudes Toward the Ethics of Research Using Social Media: A Systematic Review. J Med Internet Res. 2017;19(6):e195.

Overview: Although primarily used for social networking, social support and dissemination, data on social media platforms are increasingly used to facilitate research. However, ethical challenges in conducting social media research remain of concern. Much debated in the literature, it is the views of the public that are most pertinent to inform practice. The aim of this study was to ascertain attitudes on ethical considerations of using social media as a data source for research as expressed by social media users and researchers. A systematic review was conducted, 16 databases and 2 Internet search engines were searched in addition to handsearching, reference checking, citation searching, and contacting authors and experts. Studies that conducted any qualitative methods to collect data on attitudes on the ethical implications of research using social media were included. Quality assessment was conducted using the quality of reporting tool (QuaRT) and findings analyzed using inductive thematic synthesis. Results: In total, 17 studies met inclusion criteria. Attitudes varied from overly positive with people expressing the views about the essential nature of such research to concerns that social media research should not happen. Underlying reasons for this variation are related to issues such as the purpose and quality of the research, researcher affiliation, and potential harms. Methods used to conduct research were important. Respondents were positive about social media research while adding caveats such as the need for informed consent or use restricted to public platforms only. Conflicting issues contribute to the complexity of good ethical practice in SM research. However, this should not deter researchers from conducting it. Each Internet research project requires individual assessment of ethical issues. Guidelines on ethical conduct should be based on current evidence and standardized to avoid discrepancies between, and duplication across, different institutions, taking into consideration different jurisdictions.

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Guraya SY. The usage of social networking sites by medical students for educational purposes: A meta-analysis and systematic review. North American Journal of Medical Sciences. 2016 July 2016;8(7):268-78.

BACKGROUND: Online social networking sites (SNSs) (e.g., Facebook, MySpace, Flickr, Twitter and YouTube) have emerged as rapidly growing mechanisms to exchange personal and professional information among university students. This research aims to determine the medical students' extent of usage of SNSs for educational purposes. MATERIALS AND METHODS: Educational Resources Information Centre (ERIC), Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane library, and Excerpta Medica Data Base (EMBASE) were searched to retrieve articles from 2004 to 2014, applying predefined search terms and inclusion criteria. The extracted 10 articles were outlined in a narrative synthesis of Quality, Utility, Extent, Strength, Target and Setting of the evidence (QUESTS). RESULTS: Majority (75%) of the respondents admitted using SNSs, whereas 20% used these sites for sharing academic and educational information. No single study explored the impact of the SNSs on the academic performance. CONCLUSION: Understanding and knowledge of the significant use of SNSs by the medical students demand inclusion of such domains in medical curricula. This will train tomorrow's doctors in fostering their skills of digital technology for educational purposes

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Han CJ, Lee YJ, Demiris G. Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review. Cancer Nursing. 2017 Jul 27.

Background: Regarding cancer awareness, social media effectively promotes health and supports self-management. Given the diverse study designs, methodologies, and approaches of social media interventions in oncology, it is difficult to determine the effects of social media on cancer prevention and management. Objective: We aim to systematically review intervention studies using social media for cancer care. Methods: A systematic search, using 7 electronic databases (PubMed, Web of Science, CINAHL, Cochrane Library, Scopus, EMBASE, and PsycINFO), was conducted to identify surveys and interventions using contemporary social media tools with a focus on cancer. Results: Of the 18 selected studies, 7 were randomized controlled trials. Most studies were conducted for all types of cancer, and some were conducted for breast cancer in the United States, with mostly white female participants. Facebook was the most frequently used platform. Most studies targeted healthy participants providing cancer prevention education. With social media platforms as part of a larger intervention, or the main component of interventions, interventions were overall feasible and showed a significant improvement in cancer prevention and management. Conclusions: Social media tools have the potential to be effective in delivering interventions for cancer prevention and management. However, there was a dearth of studies with rigorous study methodologies to test social media effects on various cancer-related clinical outcomes. Implications for Practice: Social media use in cancer care will facilitate improved communication and support among patients, caregivers, and clinicians and, ultimately, improved patient care. Clinicians need to carefully harness social media to enhance patient care and clinical outcomes.

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Jones J, Salazar LF. A Review of HIV Prevention Studies that Use Social Networking Sites: Implications for Recruitment, Health Promotion Campaigns, and Efficacy Trials. AIDS Behav. 2016 Nov;20(11):2772-2781.

This review describes the use of social networking sites (SNS) in the context of primary prevention of HIV. A review was conducted to assess the published literature for HIV interventions using SNS. Sixteen articles describing twelve interventions were included. SNS were instrumental in recruiting hard-to-reach populations within a short amount of time; were able to reach wide audiences beyond the targeted population for HIV prevention campaigns; and helped to significantly reduce sexual risk behaviors and increase HIV testing. SNS are a viable option to recruit hidden populations, engage the target audience, and disseminate HIV prevention messages. Researchers should use SNS to generate sampling frames that can be used to select participants. Practitioners should use SNS to post images of preventive behavior within health promotion campaigns. Researchers should use multiple SNS platforms to engage participants. As more studies are published using SNS for HIV prevention, meta-analyses will be needed.

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Kazemi DM, Borsari B, Levine MJ, Dooley B. Systematic review of surveillance by social media platforms for illicit drug use. Journal of Public Health. 2017 Mar 1:1-4.Unique topic.PNG

Background: The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed. Methods: A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer-reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies. Results: Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items. Conclusion: Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs.

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Kingod N, Cleal B, Wahlberg A, Husted GR. Online peer-to-peer communities in the daily lives of people with chronic illness: a qualitative systematic review. Qualitative Health Research. 2017 Jan;27(1):89-99.

This qualitative systematic review investigated how individuals with chronic illness experience online peer-to-peer support and how their experiences influence daily life with illness. Selected studies were appraised by quality criteria focused upon research questions and study design, participant selection, methods of data collection, and methods of analysis. Four themes were identified: (a) illness-associated identity work, (b) social support and connectivity, (c) experiential knowledge sharing, and (d) collective voice and mobilization. Findings indicate that online peer-to-peer communities provide a supportive space for daily self-care related to chronic illness. Online communities provided a valued space to strengthen social ties and exchange knowledge that supported offline ties and patient-doctor relationships. Individuals used online communities to exchange experiential knowledge about everyday life with illness. This type of knowledge was perceived as extending far beyond medical care. Online communities were also used to mobilize and raise collective awareness about illness-specific concerns.

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Lim MS, Wright CJ, Carrotte ER, Pedrana AE. Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites. Health promotion journal of Australia. 2017 Jan 11;27(3):187-97.

Overview: Issue addressed: Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results: Forty-seven studies were included. There were two main evaluation approaches: closed designs (n = 23), which used traditional research designs and formal recruitment procedures; and open designs (n = 19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well-designed before–after evaluations, with detailed engagement metrics, it is possible to balance assessment and to evaluate SNS health promotion.

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Marchant A, Hawton K, Stewart A, Montgomery P, Singaravelu V, Lloyd K, Purdy N, Daine K, John A. A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One. 2017 Aug 16;12(8):e0181722.

BACKGROUND: Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. METHODS: We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. RESULTS: Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. CONCLUSIONS: There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums' (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518).

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McCrae N, Gettings S, Purssell E. Social Media and Depressive Symptoms in Childhood and Adolescence: A Systematic Review. Adolescent Research Review. 2017:1-6.

Concerns are increasingly raised in academic and lay literature about the impact of the internet on young people’s well-being. This systematic review examined empirical research on the relationship between social media use and depressive symptoms in the child and adolescent population. A systematic search of Medline, PsycInfo and Embase databases yielded eleven eligible studies. Relevant results were extracted from each study, with a total sample of 12,646. Analysis revealed a small but statistically significant correlation between social media use and depressive symptoms in young people. However, studies varied widely in methods, sample size and results, making the clinical significance of these findings nuanced. Over half of the studies were cross-sectional, while those of longitudinal design were of limited duration. This review justifies further investigation of this phenomenon, with a need for consensus on variables and measurement.

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Mingoia J, Hutchinson AD, Wilson C, Gleaves DH. The Relationship between Social Networking Site Use and the Internalization of a Thin Ideal in Females: A Meta-Analytic Review. Frontiers in Psychology. 2017;8. Unique topic.PNG

Previous research has indicated that exposure to traditional media (i.e., television, film, and print) predicts the likelihood of internalization of a thin ideal; however, the relationship between exposure to internet-based social media on internalization of this ideal remains less understood. Social media differ from traditional forms of media by allowing users to create and upload their own content that is then subject to feedback from other users. This meta-analysis examined the association linking the use of social networking sites (SNSs) and the internalization of a thin ideal in females. Systematic searches were performed in the databases: PsychINFO, PubMed, Web of Science, Communication and Mass Media Complete, and ProQuest Dissertations and Theses Global. Six studies were included in the meta-analysis that yielded 10 independent effect sizes and a total of 1,829 female participants ranging in age from 10 to 46 years. We found a positive association between extent of use of SNSs and extent of internalization of a thin ideal with a small to moderate effect size (r = 0.18). The positive effect indicated that more use of SNSs was associated with significantly higher internalization of a thin ideal. A comparison was also made between study outcomes measuring broad use of SNSs and outcomes measuring SNS use solely as a function of specific appearance-related features (e.g., posting or viewing photographs). The use of appearance-related features had a stronger relationship with the internalization of a thin ideal than broad use of SNSs. The finding suggests that the ability to interact with appearance-related features online and be an active participant in media creation is associated with body image disturbance. Future research should aim to explore the way SNS users interact with the media posted online and the relationship linking the use of specific appearance features and body image disturbance.

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Müller AM, Alley S, Schoeppe S, Vandelanotte C. The effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries: A systematic review. Int J Behav Nutr Phys Act. 2016 Oct 10;13(1):109.

Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. Methods: Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies. Results: A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets. Conclusions: The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers.

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Naslund JA, Kim SJ, Aschbrenner KA, McCulloch LJ, Brunette MF, Dallery J, Bartels SJ, Marsch LA. Systematic review of social media interventions for smoking cessation. Addict Behav. 2017 Oct;73:81-93.

Background: Popular social media could extend the reach of smoking cessation efforts. In this systematic review, our objectives were: 1) to determine whether social media interventions for smoking cessation are feasible, acceptable, and potentially effective; 2) to identify approaches for recruiting subjects; and 3) to examine the specific intervention design components and strategies employed to promote user engagement and retention. METHODS: We searched Scopus, Medline, EMBASE, Cochrane Central, PsychINFO, CINAHL, and Web of Science through July 2016 and reference lists of relevant articles. Included studies described social media interventions for smoking cessation and must have reported outcomes related to feasibility, acceptability, usability, or smoking-related outcomes. RESULTS: We identified 7 studies (all were published since 2014) that enrolled 9755 participants (median=136 [range 40 to 9042]). Studies mainly used Facebook (n=4) or Twitter (n=2), and emerged as feasible and acceptable. Five studies reported smoking-related outcomes such as greater abstinence, reduction in relapse, and an increase in quit attempts. Most studies (n=6) recruited participants using online or Facebook advertisements. Tailored content, targeted reminders, and moderated discussions were used to promote participant engagement. Three studies found that active participation through posting comments or liking content may be associated with improved outcomes. Retention ranged from 35% to 84% (median=70%) across the included studies. CONCLUSIONS: Our review highlights the feasibility, acceptability and preliminary effectiveness of social media interventions for smoking cessation. Future research should continue to explore approaches for promoting user engagement and retention, and whether sustained engagement translates to clinically meaningful smoking cessation outcomes.

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Nour M, Yeung SH, Partridge S, Allman-Farinelli M. A Narrative Review of Social Media and Game-Based Nutrition Interventions Targeted at Young Adults. J Acad Nutr Diet. 2017 May;117(5):735-752.e10.

The increased popularity of social media and mobile gaming among young adults provides an opportunity for innovative nutrition programs. This review evaluated the efficacy of these strategies in interventions targeted at 18- to 35-year-olds. The protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ten scientific databases, information technology conference proceedings, and gray literature were searched. Two reviewers conducted screening, data extraction, and quality assessments. Interventions were included if they used social media or electronic games. Comparisons were made pre- to post-intervention, or between intervention and control arms. Outcomes of interest included change in nutrition knowledge, attitudes, behavior, or weight and/or body composition. Eleven social media-based (randomized controlled trials [RCT] n=7) and six game-based [RCT n=1]) interventions were included. Overall quality of studies was low. Social media-based strategies included forum/blogs (n=5), Facebook (n=5), Twitter (n=1), YouTube (n=1), and chat rooms (n=1). Eight (RCT n=6) of 11 social media-based studies demonstrated improvements in outcomes. Findings suggested that social media may be more effective when combined with other strategies. Virtual reality games (n=3), web-based games (n=2), and a mobile application (n=1) were used in the gaming interventions. While a significant increase in knowledge was reported by three gaming studies (RCT=1), two used nonvalidated tools and longer-term measures of weight and behavioral outcomes were limited. The use of social media and gaming for nutrition promotion is in its infancy. Preliminary evidence suggests that these strategies have some utility for intervening with young adults. Further research using high-quality study designs is required, with measurement of outcomes over longer time periods. The systematic review protocol is registered with PROSPERO (registration number: CRD42015025427).

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O'Connor S, Jolliffe S, Stanmore E, Renwick L, Schmitt T, Booth R. A mixed study systematic review of social media in nursing and midwifery education: Protocol. J Advanced Nursing. 2017; 73(8): 1989-1996.

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O'Shea J. Digital disease detection: a systematic review of event-based internet biosurveillance systems. Int J Med Inform. 2017 May;101:15-22.

BACKGROUND: Internet access and usage has changed how people seek and report health information. Meanwhile,infectious diseases continue to threaten humanity. The analysis of Big Data, or vast digital data, presents an opportunity to improve disease surveillance and epidemic intelligence. Epidemic intelligence contains two components: indicator based and event-based. A relatively new surveillance type has emerged called event-based Internet biosurveillance systems. These systems use information on events impacting health from Internet sources, such as social media or news aggregates. These systems circumvent the limitations of traditional reporting systems by being inexpensive, transparent, and flexible. Yet, innovations and the functionality of these systems can change rapidly. AIM: To update the current state of knowledge on event-based Internet biosurveillance systems by identifying all systems, including current functionality, with hopes to aid decision makers with whether to incorporate new methods into comprehensive programmes of surveillance. METHODS: A systematic review was performed through PubMed, Scopus, and Google Scholar databases, while also including grey literature and other publication types. RESULTS: 50 event-based Internet systems were identified, including an extraction of 15 attributes for each system, described in 99 articles. Each system uses different innovative technology and data sources to gather data, process, and disseminate data to detect infectious disease outbreaks. CONCLUSIONS: The review emphasises the importance of using both formal and informal sources for timely and accurate infectious disease outbreak surveillance, cataloguing all event-based Internet biosurveillance systems. By doing so, future researchers will be able to use this review as a library for referencing systems, with hopes of learning, building, and expanding Internet-based surveillance systems. Event-based Internet biosurveillance should act as an extension of traditional systems, to be utilised as an additional, supplemental data source to have a more comprehensive estimate of disease burden.

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Overbey KN, Jaykus LA, Chapman BJ. A Systematic Review of the Use of Social Media for Food Safety Risk Communication. J Food Prot. 2017 Sep;80(9):1537-1549. Unique topic.PNG

This article covers the current published literature related to the use of social media in food safety and infectious disease communication. The aim was to analyze literature recommendations and draw conclusions about how best to utilize social media for food safety risk communication going forward. A systematic literature review was conducted, and 24 articles were included for analysis. The inclusion criteria were (i) original peer-reviewed articles and (ii) primary focus on communication through social media about food safety and/or infectious diseases. Studies were coded for themes about social media applications, benefits, limitations, and best practices. Trust and personal beliefs were important drivers of social media use. The wide reach, immediacy, and information gathering capacities of social media were frequently cited benefits. Suggestions for social media best practices were inconsistent among studies, and study designs were highly variable. More evidence-based suggestions are needed to better establish guidelines for social media use in food safety and infectious disease risk communication. The information gleaned from this review can be used to create effective messages for shaping food safety behaviors.

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Pellino G, Simillis C, Qiu S, Rasheed S, Mills S, Tekkis P, et al. Social media and colorectal cancer: a systematic review of available resources. PLoS ONE. 2017; 12(8): 1-15.

Aim: Social media (SM) can provide information and medical knowledge to patients. Our aim was to review the literature and web-based content on SM that is used by Colorectal Cancer (CRC) patients, as well as surgeons’ interaction with SM. Method: Studies published between 2006 and 2016 were assessed. We also assessed the impact of several hashtags on Twitter with a freeware (Symplur). Results: Nine studies were included assessing Twitter (78%), Forums/Cancer-survivor networks (33%), and Facebook (22%). Aims included use of SM by CRC patients (67%), cancer-specific usage of SM with different types of cancer (44%), content credibility (33%), and influence in CRC awareness (33%). Prevention was the most common information that CRC patients looked for, followed by treatment side-effects. Only 2% of CRC SM users are doctors. SM use by colorectal consultants was suboptimal. Only 38% of surgeons had a LinkedIn account (most with less than 50 connections), and 3% used Twitter. A steep increase of tweets was observed for searched Hashtags over time, which was more marked for #ColonCancer (+67%vs+38%, #Coloncancer vs #RectalCancer). Participants engaged with colon cancer increased by 85%, whereas rectal cancer ones increased by 29%. The hashtag ‘#RectalCancer’ was mostly tweeted by colorectal surgeons. The official twitter account of American Society of Colorectal Surgeons (@fascrs_updates) was the most active account. Conclusion: CRC patients and relatives are increasingly engaging with SM. CRC surgeons’ participation is poor, but we confirm a trend toward a greater involvement. Most SM lack of authoritative validation and the quality of shared content still is largely anecdotic and not scientifically evidenced-based. However, SM may offer several advantages over conventional information sharing sources for CRC patients and surgeons, and create connections with mutual enrichment

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Quigley J, Rasmussen S, McAlaney J. The associations between children's and adolescents’ suicidal and self-harming behaviors, and related behaviors within their social networks: a systematic review. Archives Of Suicide Research. 2017; 21(2):185-236.

Social influences—including the suicidal and self-harming behaviors of others—have been highlighted as a risk factor for suicidal and self-harming behavior in young people, but synthesis of the evidence is lacking. A systematic review of 86 relevant papers was conducted. Considerable published evidence was obtained for positive associations between young people’s suicidal and self-harming behavior and that of people they know, with those reporting knowing people who had engaged in suicidal or self-harming behaviors more likely to report engaging in similar behaviors themselves. Findings are discussed in relation to a number of methodological and measurement issues—including the role of normative perceptions—and implications for the prevention of suicidal and self-harming behavior are considered.

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Rachel LF, Debra JR. A systematic review of the mental health outcomes associated with Facebook use. Computers in Human Behavior. 2017 Aug 4.

The effect of social networking site (SNS) use on mental health has attracted growing scholarly attention, yet the nature of this relationship remains contentious. A systematic review was conducted to examine mental health outcomes associated specifically with the SNS, Facebook. A total of 65 articles met the inclusion criteria and were included in the review. Facebook use was associated with six key mental health domains: Facebook addiction, anxiety, depression, body image and disordered eating, drinking cognitions and alcohol use, and other mental health problems, albeit the strength and validity of these relationships varied. The review highlighted the multidimensional nature of Facebook use, and the subsequent importance of assessing specific SNS platforms or similar functions over platforms. The application of meta-analytic techniques is required to quantify the nature and direction of the relationships between Facebook use and mental health outcomes, as well as to identify pertinent moderators and individual difference factors.

River J, Currie J, Crawford T, Betihavas V, Randall S. A systematic review examining the effectiveness of blending technology with team-based learning. Nurse Educ Today. 2016 Oct;45:185-92.Unique topic.PNG

BACKGROUND: Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines. OBJECTIVES: This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference. METHOD: A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP). RESULTS: The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media. CONCLUSION: There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components.

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Robinson J, Cox G, Bailey E, Hetrick S, Rodrigues M, Fisher S, Herrman H. Social media and suicide prevention: a systematic review. Early intervention in psychiatry. 2016 Apr 1;10(2):103-21.Unique topic.PNG

Aim: Social media platforms are commonly used for the expression of suicidal thoughts and feelings, particularly by young people. Despite this, little is known about the ways in which social media can be used for suicide prevention. The aim of this study was to conduct a systematic review to identify current evidence pertaining to the ways in which social media are currently used as a tool for suicide prevention. Methods: Medline, PsycInfo, Embase, CINHAL and the Cochrane Library were searched for articles published between 1991 and April 2014. English language articles with a focus on suicide-related behaviour and social media were included. No exclusion was placed on study design. Results: Thirty studies were included; 4 described the development of social media sites designed for suicide prevention, 6 examined the potential of social media in terms of its ability to reach or identify people at risk of suicide, 15 examined the ways in which people used social media for suicide prevention-related purposes, and 5 examined the experiences of people who had used social media sites for suicide prevention purposes. No intervention studies were identified. Conclusion: Social media platforms can reach large numbers of otherwise hard-to-engage individuals, may allow others to intervene following an expression of suicidal ideation online, and provide an anonymous, accessible and non-judgmental forum for sharing experiences. Challenges include difficulties controlling user behaviour and accurately assessing risk, issues relating to privacy and confidentiality and the possibility of contagion. Social media appears to hold significant potential for suicide prevention; however, additional research into its safety and efficacy is required.

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Rose T, Barker M, Maria Jacob C, Morrison L, Lawrence W, Strömmer S, Vogel C, Woods-Townsend K, Farrell D, Inskip H, Baird J. A Systematic Review of Digital Interventions for Improving the Diet and Physical Activity Behaviors of Adolescents. J Adolesc Health. 2017 Aug 16.

Many adolescents have poor diet and physical activity behaviors, which can lead to the development of noncommunicable diseases in later life. Digital platforms offer inexpensive means of delivering health interventions, but little is known about their effectiveness. This SR was conducted to synthesize evidence on the effectiveness of digital interventions to improve diet quality and increase physical activity in adolescents, to effective intervention components and to assess the cost-effectiveness of these interventions. Following a systematic search, abstracts were assessed against inclusion criteria, and data extraction and quality assessment were performed for included studies. Data were analyzed to identify key features that are associated with significant improvement in behavior. 27 studies met inclusion criteria. Most (n = 15) were website interventions. Other delivery methods were text messages, games, multicomponent interventions, emails, and social media. Significant behavior change was often seen when interventions included education, goal setting, self-monitoring, and parental involvement. None of the publications reported cost-effectiveness. Due to heterogeneity of studies, meta-analysis was not feasible.It is possible to effect significant health behavior change in adolescents through digital interventions that incorporate education, goal setting, self-monitoring, and parental involvement. Most of the evidence relates to Web sites and further research into alternate media is needed, and longer term outcomes should be evaluated. There is a paucity of data on the cost-effectiveness of digital health interventions, and future trials should report these data.

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Seabrook EM, Kern ML, Rickard NS. Social Networking Sites, Depression, and Anxiety: A Systematic Review. JMIR Ment Health. 2016 Nov 23;3(4):e50.

BACKGROUND: Social networking sites (SNSs) have become a pervasive part of modern culture, which may also affect mental health. OBJECTIVE: The aim of this systematic review was to identify and summarize research examining depression and anxiety in the context of SNSs. It also aimed to identify studies that complement the assessment of mental illness with measures of well-being and examine moderators and mediators that add to the complexity of this environment. METHODS: A multidatabase search was performed. Papers published between January 2005 and June 2016 relevant to mental illness (depression and anxiety only) were extracted and reviewed. RESULTS: Positive interactions, social support, and social connectedness on SNSs were consistently related to lower levels of depression and anxiety, whereas negative interaction and social comparisons on SNSs were related to higher levels of depression and anxiety. SNS use related to less loneliness and greater self-esteem and life satisfaction. Findings were mixed for frequency of SNS use and number of SNS friends. Different patterns in the way individuals with depression and individuals with social anxiety engage with SNSs are beginning to emerge. CONCLUSIONS: The systematic review revealed many mixed findings between depression, anxiety, and SNS use. Methodology has predominantly focused on self-report cross-sectional approaches; future research will benefit from leveraging real-time SNS data over time. The evidence suggests that SNS use correlates with mental illness and well-being; however, whether this effect is beneficial or detrimental depends at least partly on the quality of social factors in the SNS environment. Understanding these relationships will lead to better utilization of SNSs in their potential to positively influence mental health.

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Sharma P, Kaur PD. Effectiveness of web-based social sensing in health information dissemination—A review. Telematics and Informatics. 2017 Feb 28;34(1):194-219.

Social media has moved ahead of just being a tool for adolescent users to share their personal lives (messages, pictures) but has also been taken up by healthcare stakeholders to disseminate health information worldwide. The role of social media in healthcare industry and impact of patient engagement has moved to centered-stage and is continuously propelled by patient demand, mobile technology and mounting influence of the native digital generation. The pace with which the social activity is growing, it is important to foresee what impact these web-based platforms are having on the deliverance and outcome of healthcare interventions. This survey looks at how far social media has been prove to be effective in disseminating health information and to what extent ontological advancing approaches have been helpful in extracting relevant knowledge from sheer amount of healthcare data.

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Sinnenberg L, Buttenheim AM, Padrez K, Mancheno C, Ungar L, Merchant RM. Twitter as a Tool for Health Research: A Systematic Review. Am J Public Health. 2017 Jan;107(1):e1-e8. Epub 2016 Nov 17.

Overview: Researchers have used traditional databases to study public health for decades. Less is known about the use of social media data sources, such as Twitter, for this purpose. The aim is to systematically review the use of Twitter in health research, create a taxonomy to describe Twitter use, and characterize the current state of Twitter in health research. We performed a literature search in PubMed, Embase, Web of Science, Google Scholar, and CINAHL through September 2015. We searched for peer-reviewed original research studies that primarily used Twitter for health research. Two authors independently screened studies and abstracted data related to the approach to analysis of Twitter data, methodology used to study Twitter, and current state of Twitter research by evaluating time of publication, research topic, discussion of ethical concerns, and study funding source. Of 1110 unique health-related articles mentioning Twitter, 137 met eligibility criteria. The primary approaches for using Twitter in health research that constitute a new taxonomy were content analysis (56%; n = 77), surveillance (26%; n = 36), engagement (14%; n = 19), recruitment (7%; n = 9), intervention (7%; n = 9), and network analysis (4%; n = 5). These studies collectively analyzed more than 5 billion tweets primarily by using the Twitter application program interface. Of 38 potential data features describing tweets and Twitter users, 23 were reported in fewer than 4% of the articles. The Twitter-based studies in this review focused on a small subset of data elements including content analysis, geotags, and language. Most studies were published recently (33% in 2015). Public health (23%; n = 31) and infectious disease (20%; n = 28) were the research fields most commonly represented in the included studies. Approximately one third of the studies mentioned ethical board approval in their articles. Primary funding sources included federal (63%), university (13%), and foundation (6%). We identified a new taxonomy to describe Twitter use in health research with 6 categories. Many data elements discernible from a user's Twitter profile, especially demographics, have been underreported in the literature and can provide new opportunities to characterize the users whose data are analyzed in these studies. Twitter-based health research is a growing field funded by a diversity of organizations. Future work should develop standardized reporting guidelines for health researchers who use Twitter and policies that address privacy and ethical concerns in social media research.

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Sterling M, Leung P, Wright D, Bishop TF. The Use of Social Media in Graduate Medical Education: A Systematic Review. Academic Medicine. 2017 Feb 21.

Overview: Despite the growing presence of social media in graduate medical education (GME), few studies have attempted to characterize their effect on residents and their training. The authors conducted a systematic review of the peer-reviewed literature to understand the effect of social media on resident (1) education, (2) recruitment, and (3) professionalism. The authors identified English-language peer-reviewed articles published through November 2015 using Medline, Embase, Cochrane, PubMed, Scopus, and ERIC. They extracted and synthesized data from articles that met inclusion criteria. They assessed study quality for quantitative and qualitative studies via, respectively, the Medical Education Research Study Quality Instrument and Consolidated Criteria for Reporting Qualitative Studies. Twenty-nine studies met inclusion criteria. Thirteen (44.8%) pertained to residency education; Twitter, podcasts, and blogs were frequently used to engage learners and enhance education. YouTube and wikis were more commonly used to teach technical skills and promote self-efficacy. Six studies (20.7%) pertained to the recruitment process; these suggest that GME programs are transitioning information to social media to attract applicants. Ten studies (34.5%) pertained to resident professionalism. Most were exploratory, highlighting patient and resident privacy, particularly Facebook. Four studies surveyed residents about their social network behavior with respect to patients, while the rest explored how program directors use it to monitor residents' unprofessional online behavior. The effect of SM platforms on residency education, recruitment, and professionalism is mixed, and the quality of existing studies is modest at best.

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Sutherland S, Jalali A. Social media as an open-learning resource in medical education: current perspectives. Adv Med Educ Pract. 2017 Jun 8;8:369-375.

PURPOSE:Numerous studies evaluate the use of social media as an open-learning resource in education, but there is a little published knowledge of empirical evidence that such open-learning resources produce educative outcomes, particularly with regard to student performance. This study undertook a systematic review of the published literature in medical education to determine the state of the evidence as to empirical studies that conduct an evaluation or research regarding social media and open-learning resources. METHODS: The authors searched MEDLINE, ERIC, Embase, PubMed, Scopus, and Google Scholar from 2012 to 2017. This search included using keywords related to social media, medical education, research, and evaluation, while restricting the search to peer reviewed, English language articles only. To meet inclusion criteria, manuscripts had to employ evaluative methods and undertake empirical research. RESULTS: Empirical work designed to evaluate the impact of social media as an open-learning resource in medical education is limited as only 13 studies met inclusion criteria. The majority of these studies used undergraduate medical education as the backdrop to investigate open-learning resources, such as Facebook, Twitter, and YouTube. YouTube appears to have little educational value due to the unsupervised nature of content added on a daily basis. Overall, extant reviews have demonstrated that we know a considerable amount about social media use, although to date, its impacts remain unclear. CONCLUSION: There is a paucity of outcome-based, empirical studies assessing the impact of social media in medical education. The few empirical studies identified tend to focus on evaluating the affective outcomes of social media and medical education as opposed to understanding any linkages between social media and performance outcomes. Given the potential for social media use in medical education, more empirical evaluative studies are required to determine educational value.

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Thomas TL, Schrock C, Friedman DB. Providing Health Consumers with Emergency Information: A Systematic Review of Research Examining Social Media Use During Public Crises. Journal of Consumer Health on the Internet. 2016 Apr 2;20(1-2):19-40.

This systematic review explored risk and crisis communication literature to examine how researchers have evaluated social media use in public crises. Twenty-four full-text articles were reviewed, the majority of which focused on natural disasters (n = 11). Studies were commonly descriptive in design (n = 21), used content analysis (n = 12), and examined the content and structure of messages (n = 18). Studies focused on blogs and microblogs (n = 20); social networks (n = 9); content communities (n = 4); and collaborative projects (n = 3), and the most commonly studied platforms were Twitter (n = 17) and Facebook (n = 9). Findings provide insight regarding the opportunities and challenges related to social media use during public crises.

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Tursunbayeva A, Franco M, Pagliari C. Use of social media for e-Government in the public health sector: A systematic review of published studies. Government Information Quarterly. 2017 Apr 26.

Although the intersection between social media and health has received considerable research attention, little is known about how public sector health organizations are using social media for e-Government. This systematic literature review sought to capture, classify, appraise and synthesize relevant evidence from four international research databases and gray literature. From 2441 potentially relevant search results only 22 studies fully met the inclusion criteria. This modest evidence-base is mostly descriptive, unidisciplinary and lacks the theoretical depth seen in other branches of e-Government research. Most studies were published in the last five years in medical journals, focus on Twitter and come from high income countries. The reported e-Government objectives mainly fall into Bertot et al.'s (2010) categories of transparency/accountability, democratic participation, and co-production, with least emphasis on the latter. A unique category of evaluation also emerged. The lack of robust evidence makes it difficult to draw conclusions about the effectiveness of these approaches in the public health sector and further research is warranted.

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Whitaker C, Stevelink S, Fear N. The Use of Facebook in Recruiting Participants for Health Research Purposes: A Systematic Review. J Med Internet Res. 2017 Aug 28;19(8):e290.

BACKGROUND: Social media is a popular online tool that allows users to communicate and exchange information. It allows digital content such as pictures, videos and websites to be shared, discussed, republished and endorsed by its users, their friends and businesses. Adverts can be posted and promoted to specific target audiences by demographics such as region, age or gender. Recruiting for health research is complex with strict requirement criteria imposed on the participants. Traditional research recruitment relies on flyers, newspaper adverts, radio and television broadcasts, letters, emails, website listings, and word of mouth. These methods are potentially poor at recruiting hard to reach demographics, can be slow and expensive. Recruitment via social media, in particular Facebook, may be faster and cheaper.
OBJECTIVE: The aim of this study was to systematically review the literature regarding the current use and success of Facebook to recruit participants for health research purposes.
METHODS: A literature review was completed in March 2017 in the English language using MEDLINE, EMBASE, Web of Science, PubMed, PsycInfo, Google Scholar, and a hand search of article references. Papers from the past 12 years were included and number of participants, recruitment period, number of impressions, cost per click or participant, and conversion rate extracted.
RESULTS: A total of 35 studies were identified from the United States (n=22), Australia (n=9), Canada (n=2), Japan (n=1), and Germany (n=1) and appraised using the Critical Appraisal Skills Programme (CASP) checklist. All focused on the feasibility of recruitment via Facebook, with some (n=10) also testing interventions, such as smoking cessation and depression reduction. Most recruited young age groups (16-24 years), with the remaining targeting specific demographics, for example, military veterans. Information from the 35 studies was analyzed with median values being 264 recruited participants, a 3-month recruitment period, 3.3 million impressions, cost per click of US $0.51, conversion rate of 4% (range 0.06-29.50), eligibility of 61% (range 17-100), and cost per participant of US $14.41. The studies showed success in penetrating hard to reach populations, finding the results representative of their control or comparison demographic, except for an over representation of young white women.
CONCLUSIONS: There is growing evidence to suggest that Facebook is a useful recruitment tool and its use, therefore, should be considered when implementing future health research. When compared with traditional recruitment methods (print, radio, television, and email), benefits include reduced costs, shorter recruitment periods, better representation, and improved participant selection in young and hard to reach demographics. It however, remains limited by Internet access and the over representation of young white women. Future studies should recruit across all ages and explore recruitment via other forms of social media.

Whyte W, Hennessy C. Social Media use within medical education: A systematic review to develop a pilot questionnaire on how social media can be best used at BSMS. MedEdPublish. 2017 May 11;6.

Background: Since the early 2000s social media has become a major part of our daily lives, and over the past decade it has found its way into the medical profession. Despite its ubiquity, only 5 systematic reviews exist on the subject of social medial use within medical education. The reviews conclude that there are positive correlations linked to social media use however the studies are restricted by the same limitations: a lack of quantitative data and the fact that social media research fast becomes outdated. This review will therefore examine the latest studies in order to identify which questions remain to be answered and what areas need further development in order for social media to become a credible resource within medical education. The information gained from this process will be amalgamated to create a valid questionnaire which will produce quantitative data. Methods: A systematic review of Pubmed, Cochrane, PsychINFO, ERIC & Scopus was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was from 1st January 2014 to the 12th January 2017 and included keywords linked with social media and medical education. 27 papers were identified: 12 qualitative and 15 quantitative. From this data a questionnaire was drafted and put to a focus group in order for it to be validated. Results: Six major themes were identified and analysed: community & interactivity, communication & feedback, learning theories, social media vs traditional didactic lectures, role of faculty and professionalism. Quantitative data was limited but highlighted the efficiency of social media use especially when Facebook and Twitter were used. After the analysis a validated questionnaire was produced. Conclusion: Social media can be a useful tool within the medical curriculum if implemented correctly. The final questionnaire can be used to generate quantitative data on the following questions: which platforms are most effective and for what purposes? How beneficial is social media to teaching? and What do students understand the benefits/disadvantages of academic social media platforms to be?

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Wongkoblap A, Vadillo MA, Curcin V. Researching Mental Health Disorders in the Era of Social Media: Systematic Review. Journal of Medical Internet Research. 2017 Jun;19(6).

Background: Mental illness is quickly becoming one of the most prevalent public health problems worldwide. Social network platforms, where users can express their emotions, feelings, and thoughts, are a valuable source of data for researching mental health, and techniques based on machine learning are increasingly used for this purpose. Objective: The objective of this review was to explore the scope and limits of cutting-edge techniques that researchers are using for predictive analytics in mental health and to review associated issues, such as ethical concerns, in this area of research. Methods: We performed a systematic literature review in March 2017, using keywords to search articles on data mining of social network data in the context of common mental health disorders, published between 2010 and March 8, 2017 in medical and computer science journals. Results: The initial search returned a total of 5386 articles. Following a careful analysis of the titles, abstracts, and main texts, we selected 48 articles for review. We coded the articles according to key characteristics, techniques used for data collection, data preprocessing, feature extraction, feature selection, model construction, and model verification. The most common analytical method was text analysis, with several studies using different flavors of image analysis and social interaction graph analysis. Conclusions: Despite an increasing number of studies investigating mental health issues using social network data, some common problems persist. Assembling large, high-quality datasets of social media users with mental disorder is problematic, not only due to biases associated with the collection methods, but also with regard to managing consent and selecting appropriate analytics techniques.

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Yan SJ, Chughtai AA, Macintyre CR. Utility and potential of rapid epidemic intelligence from Internet-based sources. Int J Infect Dis. 2017 Jul 29. pii: S1201-9712(17)30199-6.

Rapid epidemic detection is an important objective of surveillance to enable timely intervention, but traditional validated surveillance data may not be available in the required timeframe for acute epidemic control. Increasing volumes of data on the Internet have prompted interest in methods that could use unstructured sources to enhance traditional disease surveillance and gain rapid epidemic intelligence. The aim of this review was to summarize Internet-based methods that use freely accessible, unstructured data for epidemic surveillance and explore their timeliness and accuracy outcomes. METHODS: Steps outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist were used to guide a systematic review of research related to the use of informal or unstructured data by Internet-based intelligence methods for surveillance. RESULTS: A total 84 articles published between 2006 and 2016 relating to Internet-based public health surveillance methods were identified. Studies used search queries, social media posts, and approaches derived from existing Internet-based systems for early epidemic alerts and real-time monitoring. Most studies noted improved timeliness compared to official reporting, such as in the 2014 Ebola epidemic, where epidemic alerts were generated first from ProMED-mail. Internet-based methods showed variable correlation strength with official datasets, with some methods showing reasonable accuracy. CONCLUSIONS: The proliferation of publicly available information on the Internet has provided a new avenue for epidemic intelligence. Methodologies have been developed to collect Internet data and some systems are already used to enhance the timeliness of traditional surveillance systems. To improve the utility of Internet-based systems, the key attributes of timeliness and data accuracy should be included in future evaluations of surveillance systems.

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Yang Q. Are Social Networking Sites Making Health Behavior Change Interventions More Effective? A Meta-Analytic Review. J Health Commun. 2017 Mar;22(3):223-233.

The increasing popularity of social networking sites (SNSs) has drawn scholarly attention in recent years, and a large amount of efforts have been made in applying SNSs to health behavior change interventions. However, these interventions showed mixed results, with a large variance of effect sizes in Cohen's d ranging from -1.17 to 1.28. To provide a better understanding of SNS-based interventions' effectiveness, a meta-analysis of 21 studies examining the effects of health interventions using SNS was conducted. Results indicated that health behavior change interventions using SNS are effective in general, but the effects were moderated by health topic, methodological features, and participant features. Theoretical and practical implications of findings are discussed.

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Zhang Y, Li X. Uses of information and communication technologies in HIV self-management: A systematic review of global literature. International Journal of Information Management. 2017 Apr 30;37(2):75-83.

Information and Communication Technology (ICT) has been applied increasingly in supporting human immunodeficiency virus (HIV) prevention and treatment. The technological advances have extended to the field of HIV self-management. The objectives of this paper are to examine the design and use of ICTs in HIV self-management programs, to identify the knowledge gaps in existing practice, and to provide recommendations for future research and program development. A systematic review was conducted to search all English literature published prior to August 2016 in six electronic databases. The inclusion criteria also included either quantitative or qualitative assessments of HIV self-management programs that utilized at least one ICT platform in the program protocol. The search identified six studies conducted in Australia and the United States. The studies were diverse in sample size and enrollment criteria of study population. The major functionalities of ICT platforms (mobile phones and websites) included delivering information modules, sending medication reminders, supporting self-monitoring for medical adherence and risk behavior reduction, enhancing communication among participants, and providing easy access to HIV self-management information. The major challenges faced by self-management programs utilizing ICTs were lack of interaction and concern of privacy. The HIV self-management programs that employed ICT platforms were limited in number and geographic coverage. Most of the programs were also tested at an initial stage with small size samples and minimum technical innovation. The lack of explicit guiding theories and models on information behavior or technology use was observed in all studies. Use of ICTs in HIV self-management interventions is an emerging field. Future research would benefit from paying more attention to technical innovation and interactive features in applying ICT platform in self-management programs. The ICTs platforms, with increasing innovation in connecting people and places, can serve as a powerful tool to reduce the disparities in health care and health promotion. Future research is also needed to explore the feasibility of applying ICT platforms in self-management programs that serving populations from diverse socioeconomic background and in resource-poor settings.

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