Use of Social Media to Promote Cancer Screening and Early Diagnosis: Scoping Review (Preprint)

Abstract

BACKGROUND Social media is commonly used in public health interventions to promote cancer prevention and early diagnosis. It can rapidly deliver targeted public health messages to large numbers of people, including groups who may have more barriers to reporting symptoms and accessing cancer screening. However, there is currently little understanding about whether social media interventions to promote cancer prevention and early diagnosis are effective and how they might improve outcomes. OBJECTIVE This scoping review aimed to describe the evidence for social media interventions to promote cancer prevention and early diagnosis, including their impact on behavior change and how they facilitate behavior change. METHODS A scoping review methodology was used. Five databases and the grey literature were searched to identify qualitative and quantitative evaluations of social media interventions targeting cancer prevention and early diagnosis. Two reviewers independently reviewed each abstract. Data extraction was carried out by one author and then reviewed and verified by a second author. Data on engagement was extracted for each intervention using an adapted version of the key performance indicators and metrics related to social media use in health promotion. This measured insights, exposure, reach and differing levels of engagement, including behavior change measures. The Behavior Change Techniques Taxonomy was used to identify how interventions facilitated behavior change. RESULTS Of the 23 publications and reports included, most (16/23, 69.6%) evaluated national cancer awareness campaigns e.g. breast cancer awareness month. Most interventions delivered information via Twitter (13/23, 57%), targeted breast cancer (12/23, 52%), and measured exposure, reach and low to medium-level user engagement, such as number of likes on a post (9/23, 39%). There were fewer articles about colorectal and lung cancer campaigns than breast and prostate cancer campaigns. One study found that interventions had less reach and engagement from ethnic minority groups. A small number of articles (5/23, 22%) suggested that some types of social media interventions might improve high-level engagement, such as knowledge of cancer, and intended and actual uptake of screening. Behavior change techniques, such as providing social support and emphasizing the salience of the consequences of cancer, were used to engage users. Many national campaigns delivered fundraising messages rather than actionable health messages. CONCLUSIONS The limited available evidence suggests some types of social media interventions may improve cancer awareness and intended and actual uptake of screening. Use of evaluation frameworks and reporting standards for social media interventions could help developers plan more robust evaluations that measure behavior change. We need greater understanding of who engages with these interventions to know whether social media can be used to reduce some health inequalities. More social media interventions for colorectal and lung cancer could help to improve social norms around help-seeking and screening for these cancers. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-033592