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

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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 our wiki entry where future updates to this review will be regularly posted, including new/future papers that satisfy our criteria, and a brief thematic categorization of papers (in a table following the same format as used here). Readers of this SR are encouraged to visit this link from time to time to chart this domain for the future (beyond the 42 papers that were selected to the end of 2016). 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.


Twenty-five (25) possible new papers 2017 -

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 [serial on the Internet]. (2016, July 15), [cited August 17, 2017]; 226267-270.

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.

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.

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.

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.

Fung I, Duke C, Finch K, Snook K, Tseng P, Tse Z, et al. Ebola virus disease and social media: A systematic review. American Journal Of Infection Control [serial on the Internet]. (2016, Dec), [cited August 17, 2017]; 44(12): 1660-1671.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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 [serial on the Internet]. (2017, Apr), [cited August 16, 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.

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.

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.

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.

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.

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.

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.

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.

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.

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?

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.

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.

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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