A systematic review of the engagement with social media–delivered interventions for improving health outcomes among sexual and gender minorities

Abstract

Background Sexual and gender minority (SGM) persons face a number of physical and mental health disparities closely linked to discrimination, social stigma, and victimization. Despite the acceptability and increasing number of digital health interventions focused on improving health outcomes among SGM people, there is a lack of reviews summarizing whether and how researchers assess engagement with social media–delivered health interventions for this group. Objective The objective of this systematic review was to synthesize and critique the evidence on evaluation of engagement with social media–delivered interventions for improving health outcomes among SGM persons. Methods We conducted a literature search for studies published between January 2003 and June 2020 using 4 electronic databases. Articles were included if they were peer-reviewed, in English language, assessed engagement with a social media–delivered health intervention for improving health outcomes among sexual and gender minorities. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed quality of data reporting using the CONSORT extension for pilot and feasibility studies and CONSORT statement parallel group randomized trials. Results We included 18 articles in the review; 15 were feasibility studies and 3 were efficacy or effectiveness randomized trials. The quality of data reporting varied considerably. The vast majority of articles focused on improving HIV-related outcomes among men who have sex with men. Only three studies recruited cisgender women and/or transgender persons. We found heterogeneity in how engagement was defined and assessed. Intervention usage from social media data was the most frequently used engagement measure. Conclusion In addition to the heterogeneity in defining and assessing engagement, we found that the focus of assessment was often on measures of intervention usage only. More purposeful recruitment is needed to learn about whether, how, and why different SGM groups engage with social media-interventions. This leaves significant room for future research to expand evaluation criteria for cognitive and emotional aspects of intervention engagement in order to develop effective and tailored social media-delivered interventions for SGM people. Our findings also support the need for developing and testing social media-delivered interventions that focus on improving mental health and outcomes related to chronic health conditions among SGM persons.

Examining Social Media Experiences and Attitudes Toward Technology-Based Interventions for Reducing Social Isolation Among LGBTQ Youth Living in Rural United States: An Online Qualitative Study

“…While access to both broad band and smartphones are still lower among rural-dwelling people than those living in urban or suburban areas, smartphone ownership among rural residents has increased dramatically and it is closing the gap with suburban dwellers ( 55 ). Given that engagement with the intervention is a pre-requisite for effectiveness ( 25 , 60 ), it is crucial that development, adaptation, optimization and scaling of digital interventions for LGBTQ adolescents living in rural areas are conducted with the input, feedback, and active participation of youth with lived experience in order to increase the likelihood of users engaging with and using the interventions.…”

“…Although some research suggests that offline connections may be higher quality than online ones, these may provide valuable companionship for youth who feel socially isolated, increasing their self-esteem and perceived support ( 23 , 24 ). These characteristics highlight the potential of leveraging social media to deliver interventions that provide information and support to rural-living LGBTQ youth ( 25 ). However, social media can also be a conduit for rejection, discrimination, bullying, and other negative experiences, potentially increasing social isolation and risk for negative mental health outcomes ( 26 , 27 ).…”

“…We need intervention tools to assist these youth in enhancing their social media experience (e.g., reducing negative interactions, increasing supportive experiences) and reducing perceived social isolation. These interventions are not currently available ( 25 ).…”

The Nexuses Between Social Media Marketing Activities and Consumers’ Engagement Behaviour: A Two-Wave Time-Lagged Study

“… Escobar-Viera et al (2021) stated that there is limited literature available on social media usage and engagement. An existing study stated that “social media should utilise strategically and take deliberate initiatives to motivate and empower customers to maximise their engagement value and yield superior marketing results” ( Li et al, 2021 , p. 4).…”

Reaching the “Hard-to-Reach” Sexual and Gender Diverse Communities for Population-Based Research in Cancer Prevention and Control: Methods for Online Survey Data Collection and Management

“…This survey’s ability to reach individuals from rural areas of the state indicates that utilizing social media and USPS is likely to be an effective method for states with significant rural populations when seeking diverse engagement. Among younger SGD populations, social media has been used successfully to engage and recruit participants ( 56 ). However, its use remains limited in engaging rural and adult populations ( 15 ), both of whom remain significantly underrepresented in population-based SGD research.…”