#CRCFREE: Using Social Media to Reduce Colorectal Cancer Risk in Rural Adults

Abstract

Objectives: In this study, we pilot-tested #CRCFree, a Facebook-based intervention aimed at reducing colorectal cancer (CRC) risk in rural Appalachian adults at risk for CRC. Methods: Participants were 56 rural Appalachian adults aged > 50 years. Daily #CRCFree Facebook posts addressed diet, physical activity, and CRC screening. Participants' sociodemographics, diet, body mass index, physical activity, and CRC screening status were measured pre- and post-intervention. The Healthy Eating Index (HEI) and the Dietary Inflammatory Index (DII) assessed dietary patterns. Facebook engagement was measured throughout the intervention. A post-intervention focus group evaluated intervention acceptability. Results: Participants were Caucasian, aged 58 ± 6 years, and predominantly female (66%). Post-intervention, HEI scores increased (49.9 ± 9.9 vs 58.6 ± 12.1, p = <.001), and DII scores decreased from baseline (2.8 ± 1.1 vs 1.6 ± 1.7, p = .002). There was no change in physical activity, BMI, or CRC screening status. Focus group participants found the intervention to be educational and motivating. Conclusions: These results provide preliminary evidence to support using Facebook to address CRC risk in this population. Participants were responsive to this intervention, and Facebook is a novel and accessible modality for health promotion.

The effect of social media interventions on physical activity and dietary behaviours in young people and adults: a systematic review

“…Most of the papers were published between 2017 and 2020 (13 of 16) [ 26 – 35 , 37 , 40 , 41 ], and included the following social media platforms: Facebook, Instagram, Reddit, Twitter, and WeChat. Most data were collected within the USA (9 studies) [ 28 – 30 , 33 – 37 , 39 ], and 11 out of 18 studies targeted young adults aged between 18 and 35 years old [ 26 , 28 , 29 , 33 , 36 – 40 ] and eight included college/university students [ 28 , 33 , 36 – 40 ]. Five of the 18 studies targeted specific populations including primigravid women [ 34 ], adults at risk of colorectal cancer [ 30 ], nurses [ 32 ], and overweight or obese individuals [ 27 , 35 ].…”

“…Decreased daily caloric intake for both groups (intervention = − 41 cal, control = − 143.3 cal) not statistically significant) and decreased vegetable consumption at 6 and 12 weeks for intervention group (− 0.2 cups each time) (not statistically significant). Vogel et al (2019) [ 30 ] USA N = 500 (54.6% Female; 44.8% Male; 0.6% Other) Mean Age (SD) = 20.9 (2.0) Ethnicity: Non-Hispanic Caucasian N = 366 Native American N = 5 African American N = 13 Asian/Pacific Islander N = 6 Hispanic N = 34 Multiple Ethnicities N = 72 Target Group = Young Adults Aged 18–25 years, current smoker and current Facebook user RCT Self-reported questionnaire on diet: (healthy eating, fruit and vegetable consumption) physical activity (regular exercise engagement and MVPA) and latent class analysis on health risk behaviours (high-fat diet, low fruit and vegetable consumption, physical inactivity, poor sleep hygiene, poor stress management, heavy drinking and substance use) Medium : Facebook Type of Social Media: Interaction and Information – information about smoking cessation was posted to a private Facebook group once per day and a live counselling session was held once a week on Facebook. Control Group: Referred to smokefree.gov .…”

“…Eight of the 18 studies reported on the use of social media for interaction and information [ 26 , 27 , 29 , 32 , 34 – 36 , 41 ], of which Facebook was the main platform used. Two studies used a combination of interaction, information and gamification [ 33 , 38 ], and two used information and gamification [ 30 , 31 ], and of these studies, three used contemporary mediums of Twitter, WeChat and Reddit and were published between 2017 and 2020. In the Twitter intervention, information involved the sharing of text-based tweets by the intervention team focused on increasing physical activity, increasing fruit and vegetable intake and decreasing sugar sweetened beverage intake, and photo-based tweets of pictures and infographics related to healthy food options and healthy lifestyle tips [ 33 ].…”

“…In the intervention that used Reddit, the focus was on the sharing of information related to weight loss, and participants were encouraged to share posts, comment and vote on posts (by liking or disliking posts) within the community [ 31 ]. The Facebook intervention involved the sharing of information three times a day and challenges were created in relation to data that could be tracked and shared to Facebook from participants’ Fitbits, and included daily step totals, where prizes for highest number of steps were awarded [ 30 ]. Participants were also challenged to share a healthy adaptation of their favourite meal to Facebook [ 30 ].…”

“…All of the 18 studies measured diet-related outcomes and 10 studies measured both physical activity and diet-related outcomes [ 26 , 28 – 30 , 32 – 36 , 38 ]. The main method to generate data were through questionnaires (16 of 18) and these included validated surveys for physical activity levels and dietary intake, as well as diary and/or food recall methods [ 26 – 30 , 32 – 34 , 36 – 41 ].…”