BACKGROUND: There is evidence that social interaction has an inverse association with the development of neurodegenerative diseases. PREDICT-Parkinson Disease (PREDICT-PD) is an online UK cohort study that stratifies participants for risk of future Parkinson disease (PD).
OBJECTIVE: This study aims to explore the methodological approach and feasibility of assessing the digital social characteristics of people at risk of developing PD and their social capital within the PREDICT-PD platform, making hypotheses about the relationship between web-based social engagement and potential predictive risk indicators of PD.
METHODS: A web-based application was built to enable social interaction through the PREDICT-PD portal. Feedback from existing members of the cohort was sought and informed the design of the pilot. Dedicated staff used weekly engagement activities, consisting of PD-related research, facts, and queries, to stimulate discussion. Data were collected by the hosting platform. We examined the pattern of connections generated over time through the cumulative number of posts and replies and ego networks using social network analysis. We used network metrics to describe the bonding, bridging, and linking of social capital among participants on the platform. Relevant demographic data and Parkinson risk scores (expressed as an odd 1:x) were analyzed using descriptive statistics. Regression analysis was conducted to estimate the relationship between risk scores (after log transformation) and network measures.
RESULTS: Overall, 219 participants took part in a 4-month pilot forum embedded in the study website. In it, 200 people (n=80, 40% male and n=113, 57% female) connected in a large group, where most pairs of users could reach one another either directly or indirectly through other users. A total of 59% (20/34) of discussions were spontaneously started by participants. Participation was asynchronous, with some individuals acting as \"brokers\" between groups of discussions. As more participants joined the forum and connected to one another through online posts, distinct groups of connected users started to emerge. This pilot showed that a forum application within the cohort web platform was feasible and acceptable and fostered digital social interaction. Matching participants\' web-based social engagement with previously collected data at individual level in the PREDICT-PD study was feasible, showing potential for future analyses correlating online network characteristics with the risk of PD over time, as well as testing digital social engagement as an intervention to modify the risk of developing neurodegenerative diseases.
CONCLUSIONS: The results from the pilot suggest that an online forum can serve as an intervention to enhance social connectedness and investigate whether patterns of online engagement can impact the risk of developing PD through long-term follow-up. This highlights the potential of leveraging online platforms to study the role of social capital in moderating PD risk and underscores the feasibility of such approaches in future research or interventions.

UNASSIGNED: There is growing concern around the use of sodium nitrite (SN) as an emerging means of suicide, particularly among younger people. Given the limited information on the topic from traditional public health surveillance sources, we studied posts made to an online suicide discussion forum, \"Sanctioned Suicide,\" which is a primary source of information on the use and procurement of SN.
UNASSIGNED: This study aims to determine the trends in SN purchase and use, as obtained via data mining from subscriber posts on the forum. We also aim to determine the substances and topics commonly co-occurring with SN, as well as the geographical distribution of users and sources of SN.
UNASSIGNED: We collected all publicly available from the site\'s inception in March 2018 to October 2022. Using data-driven methods, including natural language processing and machine learning, we analyzed the trends in SN mentions over time, including the locations of SN consumers and the sources from which SN is procured. We developed a transformer-based source and location classifier to determine the geographical distribution of the sources of SN.
UNASSIGNED: Posts pertaining to SN show a rise in popularity, and there were statistically significant correlations between real-life use of SN and suicidal intent when compared to data from the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (⍴=0.727; P<.001) and the National Poison Data System (⍴=0.866; P=.001). We observed frequent co-mentions of antiemetics, benzodiazepines, and acid regulators with SN. Our proposed machine learning-based source and location classifier can detect potential sources of SN with an accuracy of 72.92% and showed consumption in the United States and elsewhere.
UNASSIGNED: Vital information about SN and other emerging mechanisms of suicide can be obtained from online forums.

This study significantly contributes to both theory and practice by providing valuable insights into the role and value of healthcare in the context of online health communities. This study highlights the increasing dependence of patients and their families on online sources for health information and the potential of technology to support individuals with health information needs. This study develops a theoretical framework by analyzing data from a cross-sectional survey using partial least squares structural equation modeling and multi-group and importance-performance map analysis. The findings of this study identify the most beneficial technology-related issues, like ease of site navigation and interaction with other online members, which have important implications for the development and management of online health communities. Healthcare professionals can also use this information to disseminate relevant information to those with chronic illnesses effectively. This study recommends proactive engagement between forum admins and participants to improve technology use and interaction, highlighting the benefits of guidelines for effective technology use to enhance users\' information-seeking processes. Overall, this study\'s significant contribution lies in its identification of factors that aid online health community participants in the information-seeking process, providing valuable information to professionals on using technology to disseminate information relevant to chronic illnesses like COPD.

The global scholarly attention has shifted toward the phenomenon of inceldom (involuntary celibacy) due to violent incidents involving self-identified incels. There is a growing number of platforms promoting the proliferation of these ideologies, and cases of violence are becoming increasingly severe. This research constitutes one of the limited empirical investigations within an Italian context. This study aims to examine the mental well-being and its associations with self-esteem and temporal perspectives among individuals identifying as incels. Fifty-eighth male subjects aged between 18 and 45 years old participated in the study. Participants, recruited through online communication channels, completed three questionnaires focused on assessing mental well-being, self-esteem, and temporal orientation. The results reveal that incel subjects exhibit low self-esteem and are inclined toward a hedonistic present-focused perspective aimed at immediate gratification rather than future planning. Of note are the data related to the future temporal perspective, which does not show any predictive value on the well-being of incel subjects. Their ability to plan for the long term, defer immediate gratification, and control behavior through the anticipation and evaluation of possible consequences appears diminished. This study discusses the implications of developing targeted intervention programs, given that the incel phenomenon is becoming increasingly widespread. It is, therefore, crucial not to underestimate the potential threat that inceldom could pose in the future.

Existing health care research, including serious illness research, often underrepresents individuals from historically marginalized communities. Capturing the nuanced perspectives of individuals around their health care communication experiences is difficult. New research strategies are needed that increase engagement of individuals from diverse backgrounds.
The aim of this study was to develop a mixed methods approach with qualitative online forums to better understand health communication experiences of individuals, including people from groups historically marginalized such as Black and Latino individuals; older adults; and people with low income, disability, or serious illness.
We used a multiphase mixed methods, community-informed research approach to design study instruments and engage participants. We engaged a diverse group of collaborators with lived experience of navigating the health care system who provided feedback on instruments, added concepts for testing, and offered guidance on creating a safe experience for participants (phase 1). We conducted a national quantitative survey between April and May 2021 across intrapersonal, interpersonal, and systems-level domains, with particular focus on interpersonal communication between patients and clinicians (phase 2). We conducted two asynchronous, qualitative online forums, a technique used in market research, between June and August 2021, which allowed us to contextualize the learnings and test concepts and messages (phase 3). Using online forums allowed us to probe more deeply into results and hypotheses from the survey to better understand the \"whys\" and \"whats\" that surfaced and to test public messages to encourage action around health.
We engaged 46 community partners, including patients and clinicians from a Federally Qualified Health Center, to inform study instrument design. In the quantitative survey, 1854 adults responded, including 50.5% women, 25.2% individuals over 65 years old, and 51.9% individuals with low income. Nearly two-thirds identified as non-Hispanic white (65.7%), 10.4% identified as non-Hispanic Black, and 15.5% identified as Hispanic/Latino. An additional 580 individuals participated in online forums, including 60.7% women, 17.4% individuals over 65 years old, and 49.0% individuals with low income. Among the participants, 70.3% identified as non-Hispanic white, 16.0% as non-Hispanic Black, and 9.5% as Hispanic/Latino. We received rich, diverse input from our online forum participants, and they highlighted satisfaction and increased knowledge with engagement in the forums.
We achieved modest overrepresentation of people who were over 65 years old, identified as non-Hispanic Black, and had low income in our online forums. The size of the online forums (N=580) reflected the voices of 93 Black and 55 Hispanic/Latino participants. Individuals who identify as Hispanic/Latino remained underrepresented, likely because the online forums were offered only in English. Overall, our findings demonstrate the feasibility of using the online forum qualitative approach in a mixed methods study to contextualize, clarify, and expound on quantitative findings when designing public health and clinical communications interventions.

This study focuses on user-perspectives related to norms, beliefs and practices concerning psychedelic substances as they are articulated in a Danish online forum. The study combines an interest in online drug research with a focus on discourse analysis to account for the dialectical relationship between individual and shared knowledge regarding the use and meaning of psychedelics.
A total of 1,865 posts from 154 threads of online discussion were coded and analyzed thematically, inspired by a socio-cognitive approach to the study of discourse. All topics were arranged into 54 categories which were further analyzed to map recurring patterns in the construction of meaning resulting in a limited number of dominant discourses.
Five dominant discourses were identified: the recreational, the therapeutic, the spiritual, the scientific and the performance discourse. We suggest that these discourses can be seen as the available frameworks which forum users draw upon and reproduce when they describe, discuss, and negotiate their understandings and uses of psychedelics.
This study demonstrates the importance of having a nuanced approach to user perceptions. Future drug policy and practice development should take these nuances into account and expect significant variation in the motives and modalities of the use of psychedelics.

BACKGROUND: A key factor in successfully reducing and quitting smoking, as well as preventing smoking relapse is access to and engagement with social support. Recent technological advances have made it possible for smokers to access social support via online community forums. While community forums associated with smoking cessation interventions are now common practice, there is a gap in understanding how and when the different types of social support identified by Cutrona and Suhr (1992) (emotional, esteem, informational, tangible, and network) are exchanged on such forums. Community forums that entail \"superusers\" (a key marker of a successful forum), like QuitNow, are ripe for exploring and leveraging promising social support exchanges on these platforms.
OBJECTIVE: The purpose of this study was to characterize the posts made on the QuitNow community forum at different stages in the quit journey, and determine when and how the social support constructs are present within the posts.
METHODS: A total of 506 posts (including original and response posts) were collected. Using conventional content analysis, the original posts were coded inductively to generate categories and subcategories, and the responses were coded deductively according to the 5 types of social support. Data were analyzed using Microsoft Excel software.
RESULTS: Overall, individuals were most heavily engaged on the forum during the first month of quitting, which then tapered off in the subsequent months. In relation to the original posts, the majority of them fit into the categories of sharing quit successes, quit struggles, updates, quit strategies, and desires to quit. Asking for advice and describing smoke-free benefits were the least represented categories. In relation to the responses, encouragement (emotional), compliment (esteem), and suggestion/advice (informational) consistently remained the most prominent types of support throughout all quit stages. Companionship (network) maintained a steady downward trajectory over time.
CONCLUSIONS: The findings of this study highlight the complexity of how and when different types of social support are exchanged on the QuitNow community forum. These findings provide directions for how social support can be more strategically employed and leveraged in these online contexts to support smoking cessation.

BACKGROUND: Cancer affects individuals, their family members, and friends, and increasingly, some of these individuals are turning to online cancer forums to express their thoughts/feelings and seek support such as asking cancer-related questions. The thoughts/feelings expressed and the support needed from these online forums may differ depending on if (1) an individual has or had cancer or (2) an individual is a family member or friend of an individual who has or had cancer; the language used in posts in these forums may reflect these differences.
OBJECTIVE: Using natural language processing methods, we aim to determine the differences in the support needs and concerns expressed in posts published on an online cancer forum by (1) users who self-declare to have or had cancer compared with (2) users who self-declare to be family members or friends of individuals with or that had cancer.
METHODS: Using latent Dirichlet allocation (LDA), which is a natural language processing algorithm and Linguistic Inquiry and Word Count (LIWC), a psycholinguistic dictionary, we analyzed posts published on an online cancer forum with the aim to delineate the language features associated with users in these different groups.
RESULTS: Users who self-declare to have or had cancer were more likely to post about LDA topics related to hospital visits (Cohen d=0.671) and use words associated with LIWC categories related to health (Cohen d=0.635) and anxiety (Cohen d=0.126). By contrast, users who declared to be family members or friends tend to post about LDA topics related to losing a family member (Cohen d=0.702) and LIWC categories focusing on the past (Cohen d=0.465) and death (Cohen d=0.181) were more associated with these users.
CONCLUSIONS: Using LDA and LIWC, we show that there are differences in the support needs and concerns expressed in posts published on an online cancer forum by users with cancer compared with family members or friends of those with cancer. Hence, responders to online cancer forums need to be cognizant of these differences in support needs and concerns and tailor their responses based on these findings.

BACKGROUND: Loneliness is a public health concern, and increasingly, individuals experiencing loneliness are seeking support on online forums, some of which focus on discussions around loneliness (loneliness forums). Some of these individuals may also seek support around loneliness on online forums not related to loneliness or well-being (nonloneliness forums). Hence, to design and implement appropriate and efficient online loneliness interventions, it is important to understand how individuals who express and seek support around loneliness on online loneliness forums communicate in nonloneliness forums; this could provide further insights into the support needs and concerns of these users.
OBJECTIVE: This study aims to explore how users who express the feeling of loneliness and seek support around loneliness on an online loneliness forum communicate in an online nonloneliness forum.
METHODS: A total of 2401 users who expressed loneliness in posts published on a loneliness forum on Reddit and had published posts in a nonloneliness forum were identified. Using latent Dirichlet allocation (a natural language processing algorithm); Linguistic Inquiry and Word Count (a psycholinguistic dictionary); and the word score-based language features valence, arousal, and dominance, the language use differences in posts published in the nonloneliness forum by these users compared to a control group of users who did not belong to any loneliness forum on Reddit were determined.
RESULTS: It was found that in posts published in the nonloneliness forum, users who expressed loneliness tend to use more words associated with the Linguistic Inquiry and Word Count categories on sadness (Cohen d=0.10) and seeking to socialize (Cohen d=0.114), and use words associated with valence (Cohen d=0.364) and dominance (Cohen d=0.117). In addition, they tend to publish posts related to latent Dirichlet allocation topics such as relationships (Cohen d=0.105) and family and friends and mental health (Cohen d=0.10).
CONCLUSIONS: There are clear distinctions in language use in nonloneliness forum posts by users who express loneliness compared to a control group of users. These findings can help with the design and implementation of online interventions around loneliness.

Electronic cigarettes (e-cigs) are an increasingly popular alternative to smoking, helping to prevent relapse in those trying to quit and with the potential to reduce harm as they are likely to be safer than standard cigarettes. Many women return to smoking in the postpartum period having stopped during pregnancy, and while this can affect their decisions about breastfeeding, little is known about women\'s opinions on using e-cigs during this period.
The aim of this study is to explore online forum users\' current attitudes, motivations, and barriers to postpartum e-cig use, particularly as a breastfeeding mother.
Data were collected via publicly accessible (identified by Google search) online forum discussions, and a priori codes identified. All transcripts were entered into NVivo for analysis, with a template approach to thematic analysis being used to code all transcripts from which themes were derived.
Four themes were identified: use, perceived risk, social support and evidence, with a number of subthemes identified within these. Women were using e-cigs to prevent postpartum return to smoking, but opinions on their safety were conflicting. They were concerned about possible transfer of harmful products from e-cigs via breastmilk and secondhand exposure, so they were actively seeking and sharing information on e-cigs from a variety of sources. Although some women were supportive of e-cig use, others provided harsh judgement for mothers who used them.
E-cigs have the potential to reduce the number of women who return to smoking in the postpartum period and potentially improve breastfeeding rates, if breastfeeding mothers have access to relevant and reliable information. Health care providers should consider discussing e-cigs with mothers at risk of returning to smoking in the postpartum period.