The second generation of Internet-based applications (i.e., Web 2.0), in which users control communication, holds promise to significantly enhance promotional efforts within social marketing campaigns. Web 2.0 applications can directly engage consumers in the creative process by both producing and distributing information through collaborative writing, content sharing, social networking, social bookmarking, and syndication. Web 2.0 can also enhance the power of viral marketing by increasing the speed at which consumers share experiences and opinions with progressively larger audiences. Because of the novelty and potential effectiveness of Web 2.0, social marketers may be enticed to prematurely incorporate related applications into promotional plans. However, as strategic issues such as priority audience preferences, selection of appropriate applications, tracking and evaluation, and related costs are carefully considered, Web 2.0 will expand to allow health promotion practitioners more direct access to consumers with less dependency on traditional communication channels.

Twitter may be a viable tool for real-time monitoring of suicide risk factors on a large scale. This study demonstrates that individuals who are at risk for suicide may be detected through social media.

BackgroundThe introduction of Apple’s iPhone provided a platform for developers to design third-party apps, which greatly expanded the functionality and utility of mobile devices for public health.ObjectiveThis study provides an overview of the developers’ written descriptions of health and fitness apps and appraises each app’s potential for influencing behavior change.MethodsData for this study came from a content analysis of health and fitness app descriptions available on iTunes during February 2011. The Health Education Curriculum Analysis Tool (HECAT) and the Precede-Proceed Model (PPM) were used as frameworks to guide the coding of 3336 paid apps.ResultsCompared to apps with a cost less than US $0.99, apps exceeding US $0.99 were more likely to be scored as intending to promote health or prevent disease (92.55%, 1925/3336 vs 83.59%, 1411/3336; P<.001), to be credible or trustworthy (91.11%, 1895/3336 vs 86.14%, 1454/3349; P<.001), and more likely to be used personally or recommended to a health care client (72.93%, 1517/2644 vs 66.77%, 1127/2644; P<.001). Apps related to healthy eating, physical activity, and personal health and wellness were more common than apps for substance abuse, mental and emotional health, violence prevention and safety, and sexual and reproductive health. Reinforcing apps were less common than predisposing and enabling apps. Only 1.86% (62/3336) of apps included all 3 factors (ie, predisposing, enabling, and reinforcing).ConclusionsDevelopment efforts could target public health behaviors for which few apps currently exist. Furthermore, practitioners should be cautious when promoting the use of apps as it appears most provide health-related information (predisposing) or make attempts at enabling behavior, with almost none including all theoretical factors recommended for behavior change.

No abstract

BackgroundAdderall is the most commonly abused prescription stimulant among college students. Social media provides a real-time avenue for monitoring public health, specifically for this population.ObjectiveThis study explores discussion of Adderall on Twitter to identify variations in volume around college exam periods, differences across sets of colleges and universities, and commonly mentioned side effects and co-ingested substances.MethodsPublic-facing Twitter status messages containing the term “Adderall” were monitored from November 2011 to May 2012. Tweets were examined for mention of side effects and other commonly abused substances. Tweets from likely students containing GPS data were identified with clusters of nearby colleges and universities for regional comparison.Results213,633 tweets from 132,099 unique user accounts mentioned “Adderall.” The number of Adderall tweets peaked during traditional college and university final exam periods. Rates of Adderall tweeters were highest among college and university clusters in the northeast and south regions of the United States. 27,473 (12.9%) mentioned an alternative motive (eg, study aid) in the same tweet. The most common substances mentioned with Adderall were alcohol (4.8%) and stimulants (4.7%), and the most common side effects were sleep deprivation (5.0%) and loss of appetite (2.6%).ConclusionsTwitter posts confirm the use of Adderall as a study aid among college students. Adderall discussions through social media such as Twitter may contribute to normative behavior regarding its abuse.

BackgroundPrescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors.ObjectiveTo determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse.MethodsTwitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic.ResultsFrom November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001).ConclusionsTwitter users who discuss prescription drug abuse online are surrounded by others who also discuss it—potentially reinforcing a negative behavior and social norm.

Despite the expanding use of social media, little has been published about its appropriate role in health promotion, and even less has been written about evaluation. The purpose of this article is threefold: (a) outline purposes for social media in health promotion, (b) identify potential key performance indicators associated with these purposes, and (c) propose evaluation metrics for social media related to the key performance indicators. Process evaluation is presented in this article as an overarching evaluation strategy for social media.

BackgroundOne of the leading causes of death in the United States (US) is suicide and new methods of assessment are needed to track its risk in real time.ObjectiveOur objective is to validate the use of machine learning algorithms for Twitter data against empirically validated measures of suicidality in the US population.MethodsUsing a machine learning algorithm, the Twitter feeds of 135 Mechanical Turk (MTurk) participants were compared with validated, self-report measures of suicide risk.ResultsOur findings show that people who are at high suicidal risk can be easily differentiated from those who are not by machine learning algorithms, which accurately identify the clinically significant suicidal rate in 92% of cases (sensitivity: 53%, specificity: 97%, positive predictive value: 75%, negative predictive value: 93%).ConclusionsMachine learning algorithms are efficient in differentiating people who are at a suicidal risk from those who are not. Evidence for suicidality can be measured in nonclinical populations using social media data.