ABSTRACT
Importance: Social media is simultaneously home to communities of users who promote eating disorders as a lifestyle and users who advocate for recovery. As studies have confirmed an association between exposure to pro-eating disorder content and engaging in disordered eating behaviors, an examination of the accuracy of and interactions with information shared in these complex and contradictory communities can provide insights into content available to users at risk. Objective: To determine the associations among themes, accuracy of information, and user engagement of eating disorder content on a short video-sharing social media platform. Design, Setting, and Participants: This qualitative study included a thematic analysis of a sample of 200 TikTok videos, as well as user engagement metrics and content creator characteristics, between February and June 2022. Data were analyzed from March to June 2022. Main Outcomes and Measures: Content themes, accuracy of information, user engagement, and the associations among these factors were identified in a sample of eating disorder videos on a social media platform. Data were analyzed with Pearson χ2, analysis of variance, linear regression, and random permutation tests. Results: Among the 200 videos assessed, 124 (62.0%) covered prorecovery content, 59 (29.5%) included pro-eating disorder content, and 17 (8.5%) contained anti-eating disorder content. Thematic analysis revealed 4 high-level themes: (1) encouraging the development or sustainment of eating disorders, (2) sharing physical or emotional experiences with eating disorders, (3) sharing narratives of recovery, and (4) social support. While the results of Pearson χ2 test indicated that videos in the prorecovery domain contained more accurate content than videos categorized in the pro-eating disorder and anti-eating disorder domains (χ24 = 157.92; P < .001), the results of analysis of variance demonstrated that there was no significant difference in user engagement between informative and misleading content (likes: F = 0.110; P = .95; comments: F = 2.031; P = .13; views: F = 0.534; P = .59; shares: F = 0.691; P = .50). Results of the 10â¯000 random permutation tests, in which all P values were between .40 and .60 regardless of the distances, suggested that there was no significant difference in user engagement among the 3 domains. Conclusions and Relevance: This mixed-methods qualitative analysis of misleading eating disorder information on social media found that pro-eating disorder and prorecovery communities were prevalent. However, social media users in the prorecovery community created more informative than misleading content. Furthermore, the study found no significant difference between users' engagement with accurate vs misleading videos, which may suggest that false information alone does not influence the virality of videos.
Subject(s)
Feeding and Eating Disorders , Social Media , Humans , Emotions , Social SupportABSTRACT
OBJECTIVE: This qualitative research examines how transgender and gender nonbinary (T/GNB) persons from South Carolina navigate informational barriers within healthcare systems. This navigation can be described through the lens of information practices, or how T/GNB participants create, seek, use, and share information to achieve desired healthcare outcomes. Special focus is given to the roles of Information and Communication Technologies (ICTs) in shaping these practices. MATERIALS AND METHODS: The research utilizes participant data from semistructured interviews and focus groups conducted with 26 T/GNB individuals focusing on their health information practices. Data analysis utilized emic/etic coding and the constant comparative method to identify themes describing transexclusionary information barriers and respondent ICT-led information practices. RESULTS: Findings note healthcare systems producing cisnormativity by design resulting in T/GNB individuals viewing healthcare spaces as exclusionary. Exclusionary barriers included over reliance on medical, expert authority ignoring T/GNB embodiment, and a lack of contextual perspective to identities. In response, T/GNB seek, create, use, and share information via ICTs to challenge exclusionary practices. DISCUSSION: T/GNB ICT use addresses systemic barriers within healthcare systems suggesting a need to reframe healthcare systems through the lens of design justice, one that values T/GNB agency in understanding and producing health knowledge. CONCLUSION: While many healthcare providers are not intentionally being transexclusionary, the design of healthcare information systems rely on cisnormative values, thus excluding many T/GNB from accessing healthcare in comfortable and safe ways. Shifting toward the values and practices of T/GNB as informed by ICT use will afford healthcare providers ways to undo barriers to care.
