Social networks : the future for health care delivery

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network – patients and providers – with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with its dynamics will affect the flow of information and potentially the allocation of health care resources

Analyzing gender inequality through large-scale Facebook advertising data

Online social media are information resources that can have a transformative power in society. While the Web was envisioned as an equalizing force that allows everyone to access information, the digital divide prevents large amounts of people from being present online. Online social media in particular are prone to gender inequality, an important issue given the link between social media use and employment. Understanding gender inequality in social media is a challenging task due to the necessity of data sources that can provide large-scale measurements across multiple countries. Here we show how the Facebook Gender Divide (FGD), a metric based on aggregated statistics of more than 1.4 Billion users in 217 countries, explains various aspects of worldwide gender inequality. Our analysis shows that the FGD encodes gender equality indices in education, health, and economic opportunity. We find gender differences in network externalities that suggest that using social media has an added value for women. Furthermore, we find that low values of the FGD are associated with increases in economic gender equality. Our results suggest that online social networks, while suffering evident gender imbalance, may lower the barriers that women have to access informational resources and help to narrow the economic gender gap

An evaluation of professional networks, co-ordination, cooperation and collaboration in the West Midlands Paediatric Palliative Care Network

Introduction: This is a report on Strand 3 of the Big Study, which studied the West Midlands Paediatric Palliative Care Network. The Big Study was funded by The Big Lottery Fund and Strand 3 of the Big Study was researched by the Centre for Nursing and Healthcare Research in the School of Health and Social Care at the University of Greenwich. 1.1 Background: The West Midlands Paediatric Palliative Care Network began as an interest group which started in the year 2000, with 6 to 10 members and grew. At one stage it was allied to the Birmingham Cancer Network and funded by the NHS Strategic Health Authority and at this stage it became more representative of services and West Midlands geography. It has existed in its current format, as a voluntary clinical network to promote paediatric palliative care and share best practice since 2009. The membership is wide and inclusive which means 30 to 40 people may attend the meetings which are held on a bimonthly basis and are hosted and supported charitably. Subgroups are now used to manage work in specific areas e.g. transition or clinical standards. There are links to other related networks with reciprocal membership and informal links to NHS commissioners who may seek advice. 1.2 Scope: This strand of the Big Study focused on the West Midlands Paediatric Palliative Care Network. The geographical area of the West Midlands Paediatric Palliative Care Network includes Birmingham, Coventry, The Black Country, Herefordshire, Shropshire, Solihull, Staffordshire, Stoke-on-Trent, Telford and Wrekin, Warwickshire and Worcestershire. All members of the WMPCCN and the organisations they represent were included in the study. Both NHS and non-NHS organisations offering clinical services to any children requiring palliative care were represented. Excluded from this study was the detailed examination of any of the other networks, e.g. children’s speciality networks or networks covering smaller geographical areas, to which members belonged. 1.3 Report: This report will present the results of an analysis of the responses to an online questionnaire and Social Network data from semi structured telephone interviews. This data was collected during the period February to June 2012. The approach included analysing the online survey data in order to understand the benefits and constraints of the network for individual members and Social Network Analysis of data derived from telephone interviews to explore the flow of knowledge, communication and information within the network. This report will consist of 3 different sections, with Section 1 focusing on children’s palliative care policy, the development of clinical networks and social network analysis concepts. Section 2 will focus on the research design and methods. Section 3 presents the results of the study and the final section provides a summary and conclusions of the analysis

Essays on Health Information Technology: Insights from Analyses of Big Datasets

The current dissertation provides an examination of health information technology (HIT) by analyzing big datasets. It contains two separate essays focused on: (1) the evolving intellectual structure of the healthcare informatics (HI) and healthcare IT (HIT) scholarly communities, and (2) the impact of social support exchange embedded in social interactions on health promotion outcomes associated with online health community use. Overall, this dissertation extends current theories by applying a unique combination of methods (natural language processing, machine learning, social network analysis, and structural equation modeling etc.) to the analyses of primary datasets. The goal of the first study is to obtain a full understanding of the underlying dynamics of the intellectual structures of HI and its sub-discipline HIT. Using multiple statistical methods including citation and co-citation analysis, social network analysis (SNA), and latent semantic analysis (LSA), this essay shows how HIT research has emerged in IS journals and distinguished itself from the larger HI context. The research themes, intellectual leadership, cohesion of these themes and networks of researchers, and journal presence revealed in our longitudinal intellectual structure analyses foretell how, in particular, these HI and HIT fields have evolved to date and also how they could evolve in the future. Our findings identify which research streams are central (versus peripheral) and which are cohesive (as opposed to disparate). Suggestions for vibrant areas of future research emerge from our analysis. The second part of the dissertation focuses on comprehensively understanding the effect of social support exchange in online health communities on individual members’ health promotion outcomes. This study examines the effectiveness of online consumer-to-consumer social support exchange on health promotion outcomes via analyses of big health data. Based on previous research, we propose a conceptual framework which integrates social capital theory and social support theory in the context of online health communities and test it through a quantitative field study and multiple analyses of a big online health community dataset. Specifically, natural language processing and machine learning techniques are utilized to automate content analysis of digital trace data. This research not only extends current theories of social support exchange in online health communities, but also sheds light on the design and management of such communities

Friending in Online Fitness Communities: Exploring Activity-Based Online Network Structure

Individuals are influenced by both direct and indirect interaction with their social contacts. While peer influence is known to affect health-related outcomes such as exercise, limited work has fully explored how social networks are structured to support (or inhibit) interaction that could lead to positive health behaviors. With the development of pervasive technology and rise of personal health and wellness tracking, increasing attention has been paid to promoting positive fitness behaviors through social interaction mechanisms in online fitness communities. This trend offers a unique opportunity to understand the opportunity structures for personal health and wellness support. Utilizing a large-scale behavioral trace dataset from the online fitness community Strava, we examine how the size of people\u27s personal network is structured by demographics (e.g. gender and age) and an economic indicator (i.e. if they pay for a premium account). We employ stochastic process models to characterize the empirical network degree distributions in this population of fitness community members. We find that gender, age and account status are associated with distinct network structure. Results have implications in the analysis and the design of health interventions that make use of network relationships in online settings

Identifying Vaccine Hesitant Communities on Twitter and their Geolocations: A Network Approach

Vaccine misinformation online may contribute to the increase of anti-vaccine sentiment and vaccine-hesitant behaviors. Social network data was used to identify Twitter vaccine influencers, their online twitter communities, and their geolocations to determine pro-vaccine and vaccine-hesitant online communities. We explored 139,433 tweets and identified 420 vaccine Twitter influencers—opinion leaders and assessed 13,487 of their tweets and 7,731 of their connections. Semantic network analysis was employed to determine twitter conversation themes. Results suggest that locating social media influencers is an efficient way to identify and target vaccine-hesitant communities online. We discuss the implications of using this process for public health education and disease management

How patients contribute to an online psychoeducation forum for bipolar disorder: a virtual participant observation study

Background: In a recent exploratory randomized controlled trial, an online psychoeducation intervention for bipolar disorder has been found to be feasible and acceptable to patients and may positively impact on their self-management behaviors and quality of life. Objective: The objective of the study was to investigate how these patients contribute to an online forum for bipolar disorder and the issues relevant for them. Methods: Participants in the intervention arm of the Bipolar Interactive PsychoEDucation (“BIPED”) trial were invited to contribute to the Beating Bipolar forum alongside receiving interactive online psychoeducation modules. Within this virtual participant observation study, forum posts were analyzed using thematic analysis, incorporating aspects of discourse analysis. Results: The key themes which arose from the forum posts included: medication, employment, stigma, social support, coping strategies, insight and acceptance, the life chart, and negative experiences of health care. Participants frequently provided personal narratives relating to their history of bipolar disorder, life experiences, and backgrounds, which often contained emotive language and humor. They regularly sought and offered advice, and expressed encouragement and empathy. The forum would have benefitted from more users to offer a greater support network with more diverse views and experiences. Conclusions: Online forums are inexpensive to provide and may offer peer support and the opportunity for patients to share their experiences and explore issues related to their illness anonymously. Future research should focus on how to enhance patient engagement with online health care forums

Expression and Reception: An Analytic Method for Assessing Message Production and Consumption in CMC

This article presents an innovative methodology to study computer-mediated communication (CMC), which allows analysis of the multi-layered effects of online expression and reception. The methodology is demonstrated by combining the following three data sets collected from a widely tested eHealth system, the Comprehensive Health Enhancement Support System (CHESS): (1) a flexible and precise computer-aided content analysis; (2) a record of individual message posting and reading; and (3) longitudinal survey data. Further, this article discusses how the resulting data can be applied to online social network analysis and demonstrates how to construct two distinct types of online social networks—open and targeted communication networks—for different types of content embedded in social networks

The Impact of Social Media on Panic During the COVID-19 Pandemic in Iraqi Kurdistan: Online Questionnaire Study

Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people’s mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan

Engaging ‘hard to reach’ groups in health promotion: the views of older people and professionals from a qualitative study in England

Background Older people living in deprived areas, from black and minority ethnic groups (BME) or aged over 85 years (oldest old) are recognised as ‘hard to reach’. Engaging these groups in health promotion is of particular importance when seeking to target those who may benefit the most and to reduce health inequalities. This study aimed to explore what influences them practicing health promotion and elicit the views of cross-sector professionals with experiences of working with ‘hard to reach’ older people, to help inform best practice on engagement. Methods ‘Hard to reach’ older people were recruited through primary care by approaching those not attending for preventative healthcare, and via day centres. Nineteen participated in an interview (n = 15) or focus group (n = 4); including some overlaps: 17 were from a deprived area, 12 from BME groups, and five were oldest old. Cross-sector health promotion professionals across England with experience of health promotion with older people were identified through online searches and snowball sampling. A total of 31 of these 44 professionals completed an online survey including open questions on barriers and facilitators to uptake in these groups. Thematic analysis was used to develop a framework of higher and lower level themes. Interpretations were discussed and agreed within the team. Results Older people’s motivation to stay healthy and independent reflected their everyday behaviour including practicing activities to feel or stay well, level of social engagement, and enthusiasm for and belief in health promotion. All of the oldest old reported trying to live healthily, often facilitated by others, yet sometimes being restricted due to poor health. Most older people from BME groups reported a strong wish to remain independent which was often positively influenced by their social network. Older people living in deprived areas reported reluctance to undertake health promotion activities, conveyed apathy and reported little social interaction. Cross-sector health professionals consistently reported similar themes as the older people, reinforcing the views of the older people through examples. Conclusions The study shows some shared themes across the three ‘hard-to-reach’ groups but also some distinct differences, suggesting that a carefully outlined strategy should be considered to reach successfully the group targeted.Peer reviewedFinal Published versio