BACKGROUND: Peer support for chronic pain is increasingly taking place on social media via social networking communities. Several theories on the development and maintenance of chronic pain highlight how rumination, catastrophizing, and negative social interactions can contribute to poor health outcomes. However, little is known regarding the role web-based health discussions play in the development of negative versus positive health attitudes relevant to chronic pain.
OBJECTIVE: This study aims to investigate how participation in online peer-to-peer support communities influenced pain expressions by examining how the sentiment of user language evolved in response to peer interactions.
METHODS: We collected the comment histories of 199 randomly sampled Reddit (Reddit, Inc) users who were active in a popular peer-to-peer chronic pain support community over 10 years. A total of 2 separate natural language processing methods were compared to calculate the sentiment of user comments on the forum (N=73,876). We then modeled the trajectories of users\' language sentiment using mixed-effects growth curve modeling and measured the degree to which users affectively synchronized with their peers using bivariate wavelet analysis.
RESULTS: In comparison to a shuffled baseline, we found evidence that users entrained their language sentiment to match the language of community members they interacted with (t198=4.02; P<.001; Cohen d=0.40). This synchrony was most apparent in low-frequency sentiment changes unfolding over hundreds of interactions as opposed to reactionary changes occurring from comment to comment (F2,198=17.70; P<.001). We also observed a significant trend in sentiment across all users (β=-.02; P=.003), with users increasingly using more negative language as they continued to interact with the community. Notably, there was a significant interaction between affective synchrony and community tenure (β=.02; P=.02), such that greater affective synchrony was associated with negative sentiment trajectories among short-term users and positive sentiment trajectories among long-term users.
CONCLUSIONS: Our results are consistent with the social communication model of pain, which describes how social interactions can influence the expression of pain symptoms. The difference in long-term versus short-term affective synchrony observed between community members suggests a process of emotional coregulation and social learning. Participating in health discussions on Reddit appears to be associated with both negative and positive changes in sentiment depending on how individual users interacted with their peers. Thus, in addition to characterizing the sentiment dynamics existing within online chronic pain communities, our work provides insight into the potential benefits and drawbacks of relying on support communities organized on social media platforms.

BACKGROUND: Fake health-related news has spread rapidly through the internet, causing harm to individuals and society. Despite interventions, a fenbendazole scandal recently spread among patients with lung cancer in South Korea. It is crucial to intervene appropriately to prevent the spread of fake news.
OBJECTIVE: This study investigated the appropriate timing of interventions to minimize the side effects of fake news.
METHODS: A simulation was conducted using the susceptible-infected-recovered (SIR) model, which is a representative model of the virus spread mechanism. We applied this model to the fake news spread mechanism. The parameters were set similarly to those in the digital environment, where the fenbendazole scandal occurred. NetLogo, an agent-based model, was used as the analytical tool.
RESULTS: Fake news lasted 278 days in the absence of interventions. As a result of adjusting and analyzing the timing of the intervention in response to the fenbendazole scandal, we found that faster intervention leads to a shorter duration of fake news (intervention at 54 days = fake news that lasted for 210 days; intervention at 16 days = fake news that lasted for 187 days; and intervention at 10 days = fake news that lasted for 157 days). However, no significant differences were observed when the intervention was performed within 10 days.
CONCLUSIONS: Interventions implemented within 10 days were effective in reducing the duration of the spread of fake news. Our findings suggest that timely intervention is critical for preventing the spread of fake news in the digital environment. Additionally, a monitoring system that can detect fake news should be developed for a rapid response.

BACKGROUND: Social isolation is frequent in people with psychosis, contributing to negative health outcomes. Interventions including online social networking (OSN) may overcome some psychosis-related barriers and facilitate social interactions. However, evidence is currently sparse and needs to be collated in a systematic review to better understand effectiveness.
METHODS: Following PRISMA guidelines, this review yielded 9835 results. Eleven publications, reporting data from five RCTs and six non-controlled studies, met the inclusion criteria. Two independent reviewers undertook data extraction and quality assessment, with results narratively synthesised.
RESULTS: This review looked broadly at interventions including either purpose-build platforms for peer-to-peer interactions or existing OSN tools. Yet, we only identified interventions utilising purpose-designed platforms. Early small-scale studies suggested OSN interventions reduced social isolation, but larger effectiveness studies did not confirm these effects. No improvements in quality-of-life outcomes were identified.
CONCLUSIONS: Higher quality and longer-term studies did not support effectiveness of current OSN interventions in reducing social isolation or improving quality of life of people with psychosis. These interventions used purpose-built platforms and encouraged OSN between selected individuals, which may explain these outcomes. Future research may explore promoting safe use of mainstream OSN platforms to expand the social networks of individuals with psychosis.

We develop a simulation framework for studying misinformation spread within online social networks that blends agent-based modeling and natural language processing techniques. While many other agent-based simulations exist in this space, questions over their fidelity and generalization to existing networks in part hinder their ability to drive policy-relevant decision making. To partially address these concerns, we create a \'digital clone\' of a known misinformation sharing network by downloading social media histories for over ten thousand of its users. We parse these histories to both extract the structure of the network and model the nuanced ways in which information is shared and spread among its members. Unlike many other agent-based methods in this space, information sharing between users in our framework is sensitive to topic of discussion, user preferences, and online community dynamics. To evaluate the fidelity of our method, we seed our cloned network with a set of posts recorded in the base network and compare propagation dynamics between the two, observing reasonable agreement across the twin networks over a variety of metrics. Lastly, we explore how the cloned network may serve as a flexible, low-cost testbed for misinformation countermeasure evaluation and red teaming analysis. We hope the tools explored here augment existing efforts in the space and unlock new opportunities for misinformation countermeasure evaluation, a field that may become increasingly important to consider with the anticipated rise of misinformation campaigns fueled by generative artificial intelligence.

The COVID pandemic has had a major impact on the mental health of the population, especially on female adolescents. Eating disorders and gender identity problems have increased markedly. Online activities have also grown enormously during this period occupying a large portion of adolescents\' time. We explore the use of social networking and online gaming by adolescent girls and boys. We discuss their possible influence on different levels of psychological distress in boys and girls in the face of the pandemic. We propose that online games, mainly used by young boys, might offer them some emotional protection through mechanisms related to the body and its experience, to the group dynamics of competition, collaboration, and hierarchy, to the possibility of expressing aggression, and to the construction of a clearer and more stable identity. An unprejudiced look at new technologies is mandatory, if we are to avoid projecting our fears and expectations onto them.

People tend to befriend others similar to themselves, generating a pattern called homophily. However, existing studies on friendship patterns often rely on surveys that assess the perspective of relatively few participants on their friendships but do not measure actualized friendship patterns. Here, we used data from a large Slovakian online social network to assess the role of gender, age, and body mass index (BMI) in same-gender online connections among more than 400,000 users. We found that age and BMI homophily occurred in both men\'s and women\'s same-gender connections, but somewhat more strongly among men\'s. Yet, as women diverged in BMI, their connections were less likely to be reciprocated. We discuss how the evolutionary legacy of men\'s coalitional competition (e.g., warfare) and women\'s mating competition or recruitment of allocare providers might contribute to these patterns in modern same-gender relationships. For example, men\'s engagement in physical activities may lead to similar formidability levels among their same-gender peers. Altogether, our findings highlight the importance of trait similarity to same-gender friendship patterns.

Dermatological conditions are one of the most common reasons for clinical visits. Not only can they have a profound effect on patients\' cosmetic appearances, but they also have a notable impact on their self-esteem, confidence, and body image, ultimately causing psychological distress. As social networking platforms become the new public space for discussion, patients have transitioned from in-person support groups to seeking online advice, support, and guidance. We conducted queries across various social networking platforms to identify and analyze active social networking support groups for common dermatological conditions. Thirty-six online support groups were identified for the top four dermatological conditions with the highest disability-adjusted life years (DALYs). We analyzed, recorded, and categorized each group according to target dermatological condition, social networking platform, support group host, engagement rate, and content of posts. In the groups identified, the majority were patient-driven (88.89%). When evaluating the engagement activity and frequency, 77.78% (n = 28) of groups had daily posts and 22.22% (n = 8) posted weekly. Additionally, we discovered a notable feature among support groups on Facebook and Reddit being more interactive and collaborative. This underscores the importance of enabling patients with dermatological conditions to generate posts and engage in open discourse, rather than absorbing single-user generated content from other popular platforms. Understanding the current landscape of social networking support groups can aid clinicians in disseminating information and resources for patients to create communities with other patients.

OBJECTIVE: Social media allows individuals to access a vast amount of health-related information immediately and anonymously, a fact that is turning these platforms into one of the primary sources of reference in this area, especially for younger generations. Given this reality, the objective of determining the impact of social media on digital health literacy in the general Spanish population was proposed.
METHODS: A cross-sectional descriptive study was carried out in 2023. Using a non-probabilistic sampling, the population residing in Spain, over eighteen years old, and users of social networks were included, obtaining a sample of 1,307 participants. An adaptation of the validated eHEALS questionnaire on digital health literacy was used. This questionnaire, created in Microsoft Forms, was disseminated through an anonymous link via the research team\'s social networks and collaborators. A descriptive and inferential statistical analysis was performed using SPSS 22.0, assuming a significance level with a value of p<0.05.
RESULTS: All participants affirmed having consumed health information through social networks, but 72.1% stated they had actively used these platforms to search for this health information. Regarding digital health literacy, a median score of 24 out of 40 points was obtained on the questionnaire, being significantly higher among those who claimed to use social networks as a source of health information (p=0.0001).
CONCLUSIONS: Actively employing social media as a source of health information is associated with a higher level of digital health literacy.
OBJECTIVE: Las redes sociales permiten a las personas acceder de manera inmediata y anónima a una cantidad ingente de información sobre aspectos de salud, hecho que está provocando que se estén convirtiendo en una de las fuentes de referencia en este ámbito, sobre todo para las generaciones más jóvenes. Atendiendo a esta realidad se planteó el objetivo de determinar el impacto de las redes sociales en la alfabetización digital en salud en la población general española.
METHODS: Se realizó un estudio descriptivo transversal en el año 2023. Mediante un muestreo no probabilístico, se incluyó población residente en España, mayor de dieciocho años y usuaria de redes sociales, obteniendo una muestra de 1.307 participantes. Se utilizó una adaptación del cuestionario validado eHEALS sobre alfabetización digital en salud. Dicho cuestionario, elaborado en Microsoft Forms, fue difundido mediante un enlace anónimo a través de las redes sociales del equipo investigador y colaboradores. Se realizó un análisis estadístico descriptivo e inferencial mediante SPSS 22.0, asumiendo un nivel de significación con un valor de p<0,05.
RESULTS: La totalidad de los participantes afirmaron haber consumido información sobre salud a través de redes sociales, pero fue el 72,1% el que afirmó haber usado estas plataformas activamente para buscar esta información sobre salud. Con respecto a la alfabetización digital en salud, se obtuvo una puntuación mediana en el cuestionario de 24 sobre 40 puntos, siendo significativamente mayor entre los que afirmaron usar las redes sociales como fuente de información sobre salud (p=0,0001).
CONCLUSIONS: Emplear de manera activa las redes sociales como fuente de información sobre salud parece tener relación con un mayor nivel de alfabetización digital en salud.

BACKGROUND: Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.
OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.
METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.
RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users\' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.
CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.
BACKGROUND: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.

Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on \"How social media works\" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists\' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.