Social media platforms generate billions of dollars in revenue from U.S. youth: Findings from a simulated revenue model.

Social media platforms are suspected to derive hefty profits from youth users who may be vulnerable to negative mental health outcomes, including depression, anxiety, and eating disorders. Platforms, however, are not required to make these data publicly available, which may limit the abilities of researchers and policymakers to adequately investigate and regulate platform practices. This study aimed to estimate the number of U.S.-based child (0-12 years old) and adolescent (13-17 years old) users and the annual advertising revenue generated from youth across six major platforms. Data were drawn from public survey and market research sources conducted in 2021 and 2022. A simulation analysis was conducted to derive estimates of the number of users and the annual advertising revenue per age group and overall (ages 0-17 years) for 2022. The findings reveal that, across six major social media platforms, the 2022 annual advertising revenue from youth users ages 0-17 years is nearly $11 billion. Approximately 30-40% of the advertising revenue generated from three social media platforms is attributable to young people. Our findings highlight the need for greater transparency from social media platforms as well as regulation of potentially harmful advertising practices that may exploit vulnerable child and adolescent social media users.

Measuring the monetization strategies of websites with application to pro- and anti-vaccine communities.

Anti-vaccine content and other kinds of misinformation are hypothesized to be more heavily monetized than other kinds of online content. We test this hypothesis by applying several novel and scalable measures of website monetization strategies to more than 400,000 links shared by 261 anti-vaccine Facebook pages and 190 pro-vaccine ones. Contrary to expectations, websites promoted in pro-vaccine venues do more to monetize attention than those promoted in anti-vaccine venues. This is a consequence of how intensely monetized news websites are-pro-vaccine venues share more links to news. The specific news sites shared by anti-vaccine venues are rated less credible by fact-checking organizations, but we find little substantive difference in their monetization strategies. These results emphasize the need to interpret measures of monetization within the context of the broader "attention economy".

Increasing a Dermatologist's Footprint on Instagram: An Analysis of Top Influencers Performing Nonsurgical Cosmetic Procedures.

BACKGROUND: Patients use social media to find information about cosmetic procedures, yet dermatologists historically lack a social media presence. Misleading information from nonexperts is potentially harmful. OBJECTIVE: To identify the top influencers posting about nonsurgical cosmetic procedures on Instagram, verify their credentials, and analyze their content to empower dermatologists to effectively join the online conversation, combat harmful misinformation, and preserve the expertise and influence of board-certified dermatologists. METHODS AND MATERIALS: Using the Klear marketing platform, Instagram influencers with more than 50,000 followers were identified. Influence rating, top posts, and other metrics were extracted using proprietary algorithms. RESULTS: Ninety nine influencers were identified. Of the top 10, 70% were board-certified plastic surgeons. Physicians not board-certified in a core cosmetic specialty had the highest influencer rating and number of followers. The most popular posts were of before and after photographs and personal posts. CONCLUSION: Dermatologists may be able to increase their Instagram footprint by posting frequently, especially of before and after and personal photographs, using hashtags, Instagram live and Instagram television, and Instagram stories. It is important for the dermatology community to find a way to ethically navigate social media to have a seat at the table and meet patients where they are.

Evolution of diversity and dominance of companies in online activity.

Ever since the web began, the number of websites has been growing exponentially. These websites cover an ever-increasing range of online services that fill a variety of social and economic functions across a growing range of industries. Yet the networked nature of the web, combined with the economics of preferential attachment, increasing returns and global trade, suggest that over the long run a small number of competitive giants are likely to dominate each functional market segment, such as search, retail and social media. Here we perform a large scale longitudinal study to quantify the distribution of attention given in the online environment to competing organisations. In two large online social media datasets, containing more than 10 billion posts and spanning more than a decade, we tally the volume of external links posted towards the organisations' main domain name as a proxy for the online attention they receive. We also use the Common Crawl dataset-which contains the linkage patterns between more than a billion different websites-to study the patterns of link concentration over the past three years across the entire web. Lastly, we showcase the linking between economic, financial and market data by exploring the relationships between online attention on social media and the growth in enterprise value in the electric carmaker Tesla. Our analysis shows that despite the fact that we observe consistent growth in all the macro indicators-the total amount of online attention, in the number of organisations with an online presence, and in the functions they perform-we also observe that a smaller number of organisations account for an ever-increasing proportion of total user attention, usually with one large player dominating each function. These results highlight how evolution of the online economy involves innovation, diversity, and then competitive dominance.

Income-Generating Processes of Free Web-Based Digital Health Tools to Engage Patients: Qualitative Analysis.

BACKGROUND: In recent years, digital tools have become a viable means for patients to address their health and information needs. Governments and health care organizations are offering digital tools such as self-assessment tools, symptom tracking tools, or chatbots. Other sources of digital tools, such as those offered through patient platforms, are available on the internet free of charge. We define patient platforms as health-specific websites that offer tools to anyone with internet access to engage them in their health care process with peer networks to support their learning. Although numerous social media platforms engage users without up-front charges, patient platforms are specific to health. As little is known about their business model, there is a need to understand what else these platforms are trying to achieve beyond supporting patients so that patients can make informed decisions about the benefits and risks of using the digital tools they offer. OBJECTIVE: The aim of this study is to explore what patient platforms are trying to achieve beyond supporting patients and how their digital tools can be used to generate income. METHODS: Textual and visual data collected from a purposeful selection of 11 patient platforms from September 2013 to August 2014 were analyzed using framework analysis. Data were systematically and rigorously coded and categorized according to key issues and themes by following 5 steps: familiarizing, identifying a thematic framework, indexing, charting, and mapping and interpretation. We used open coding to identify additional concepts not captured in the initial thematic framework. This paper reports on emergent findings on the business models of the platforms and their income-generating processes. RESULTS: Our analysis revealed that in addition to patients, the platforms support other parties with interests in health and information exchanges. Patient platforms did not charge up-front fees but generated income from other sources, such as advertising, sponsorship, marketing (eg, sending information to users on behalf of sponsors or providing means for sponsors to reach patients directly), supporting other portals, and providing research services. CONCLUSIONS: This study reports on the mechanisms by which some patient platforms generate income to support their operations, gain profit, or both. Although income-generating processes exist elsewhere on social media platforms in general, they pose unique challenges in the health context because digital tools engage patients in health and information exchanges. This study highlights the need to minimize the potential for unintended consequences that can pose health risks to patients or can lead to increased health expenses. By understanding other interests that patient platforms support, our findings point to important policy implications, such as whether (and how) authorities might protect users from processes that may not always be in their best interests and can potentially incur costs to the health system.

Instacash: The Ethics of Leveraging Medical Student Status on Social Media.

Some medical students leverage their medical student status for profit as social media influencers on platforms such as Instagram. Depending on the size of their following and the brand they are promoting, students can make thousands of dollars per year by advertising products ranging from scrubs to protein powder to mattresses. Yet, they receive few tools as part of their education to help them understand how to reconcile their professional obligations with a desire to generate an income. After examining the potential benefits and harms of social media use, this article considers the possibility of medical student financial gain from being an influencer in light of seasoned physicians' own efforts to profit from industry alliances. Through both historical and contemporary lenses, the authors consider the tension between doctors as healers and moneymakers, before concluding with practical and philosophical approaches for guiding medical student influencers.

#PlasticSurgery: A Comparative Deep Dive Analysis into Social Media and Plastic Surgery.

BACKGROUND: As social media have become pervasive in contemporary society, plastic surgery content has become commonplace. Two of the most engaging and popular platforms are Instagram and Twitter, and much research has been performed with respect to Twitter. Currently, there are no studies comparing and contrasting the two platforms. The aim of this study was to robustly sample plastic surgery posts on Twitter and Instagram to quantitatively and qualitatively evaluate platform content differences. METHODS: The hashtag #PlasticSurgery was systematically queried twice per day, for 30 consecutive days, on Twitter and Instagram. Account type, specific media content, possible patient-identifying information, content analysis, and post engagement were assessed. Post volume and engagement between Instagram and Twitter posts were compared. Post characteristics garnering high engagement from each platform were also evaluated. RESULTS: A total of 3867 Twitter posts and 5098 Instagram posts were included in this analysis. Daily total post volume for the 1-month duration of the study was significantly higher on Instagram compared with Twitter. Overall post engagement was significantly higher on Instagram compared with Twitter. Plastic surgeons and plastic surgery clinics represented the majority of accounts posting on both platforms with #PlasticSurgery. Identifiable patient features were much more prevalent on Instagram. The majority of Instagram posts were promotional in nature, outcome-based, or unrelated to plastic surgery. Alternatively, tweets were predominantly educational in nature. CONCLUSIONS: For physicians to harness the power of social media in plastic surgery, we need to understand how these media are currently being used and how different platforms compare to one another. This study has highlighted the inherent similarities and differences between these two highly popular platforms.

Crowdfunding Campaigns and Thyroid Surgery: Who, What, Where, and How Much?

BACKGROUND: Crowdfunding has become a unique response to the challenge of health care expenses, yet it has been rarely studied by the medical community. We looked to describe the scope of crowdfunding in thyroid surgery and analyze the factors that contribute toward a successful campaign. METHODS: In November 2018, active campaigns were retrieved from a popular crowdfunding Web site using search terms thyroidectomy and thyroid surgery and filtered to include only campaigns that originated in the United States. RESULTS: About 1052 thyroid surgery-related campaigns were analyzed. About 836 (79.5%) involved female patients and 43 (4.1%) pediatric patients. About 792 campaigns (75.3%) referred to thyroid cancer as a primary condition, 163 (15.5%) benign thyroid disease, and 97 (9.2%) other conditions. The average amount raised per campaign was $2514.54 (range, $0-$53,160). About 338 (32.1%) campaigns were self-posted, 317 (30.1%) posted by family, and 397 (37.7%) posted by friends. Median campaign duration was 20 mo, with a median number of 16 donors, 17 hearts, and 136 social media shares. Campaigns related to thyroid cancer raised more funds ($2729.97) than benign ($1669.84) or other ($2175.03) conditions (P < 0.001). Campaigns submitted by friends ($3524.78) received more funding than those by self ($1672.48) or family ($2147.19) (P < 0.001). Campaign duration, donor number, share number, and hearts were also significant predictors of amount raised. CONCLUSIONS: For thyroid surgery-related crowdfunding, campaigns referring to thyroid cancer had the highest amount of funds raised. Campaigns created by friends and other factors related to increased community engagement such as social media shares were also related to increased funds.

Innovative Recruitment Strategies to Increase Diversity of Participation in Parkinson's Disease Research: The Fox Insight Cohort Experience.

BACKGROUND: Clinical research in Parkinson's disease (PD) faces practical and ethical challenges due to two interrelated problems: participant under-recruitment and lack of diversity. Fox Insight (FI) is a web-based longitudinal study collecting patient-reported outcomes and genetic data worldwide to inform therapeutic studies. FI's online platform provides an opportunity to evaluate online strategies for recruiting large, diverse research cohorts. OBJECTIVE: This project aimed to determine 1) whether FI's digital marketing was associated with increased enrollment overall and from under-represented patient groups, compared to traditional recruitment methods; 2) the clinical and demographic characteristics of samples recruited online, and 3) the cost of this online recruitment. METHOD: FI recruitment during a 6-week baseline period without digital promotion was compared to recruitment during several periods of digital outreach. Separate online recruiting intervals included general online study promotion and unique Facebook and Google ad campaigns targeting under-represented subgroups: early PD, late/advanced PD, and residents of underrepresented/rural geographic areas. RESULTS: Early PD, late PD, and geotargeting campaigns enrolled more individuals in their respective cohorts compared to baseline. All online campaigns also yielded greater total FI enrollment, attracting more participants who were non-White, Hispanic, older, female, and had lower educational attainment and income, and more medical comorbidities. Cost per new participant ranged from $21 (Facebook) to $108 (Google). CONCLUSION: Digital marketing may allow researchers to increase, accelerate, and diversify recruitment for PD clinical studies, by tailoring digital ads to target PD cohort characteristics.

Under his thumb the effect of president Donald Trump's Twitter messages on the US stock market.

Does president Trump's use of Twitter affect financial markets? The president frequently mentions companies in his tweets and, as such, tries to gain leverage over their behavior. We analyze the effect of president Trump's Twitter messages that specifically mention a company name on its stock market returns. We find that tweets from the president which reveal strong negative sentiment are followed by reduced market value of the company mentioned, whereas supportive tweets do not render a significant effect. Our methodology does not allow us to conclude about the exact mechanism behind these findings and can only be used to investigate short-term effects.

Digital posters for interactive cellular media and bioengineering education.

Conventional posters are effective in disseminating progress reports in scientific meetings, but they fail to deliver the need for visualization of dynamic biological data and become costly with the increasing number of conferences and the reprinting needs for emerging research. Here we present digital posters that repurpose digital frames from the art community and experiment with multiplexed imaging movies of cells as a demonstration of the digital poster concept, providing an interactive and low-cost tool for next-generation sharing platforms.

Cost and Effectiveness of Using Facebook Advertising to Recruit Young Women for Research: PREFER (Contraceptive Preferences Study) Experience.

BACKGROUND: Social media is a popular and convenient method for communicating on the Web. The most commonly used social networking website, Facebook, is increasingly being used as a tool for recruiting research participants because of its large user base and its ability to target advertisements on the basis of Facebook users' information. OBJECTIVE: We evaluated the cost and effectiveness of using Facebook to recruit young women into a Web-based intervention study (PREFER). The PREFER study aimed to determine whether an educational video could increase preference for and uptake of long-acting reversible contraception (LARC). METHODS: We placed an advertisement on Facebook over a 19-day period from December 2017 to January 2018, inviting 16- to 25-year-old women from Australia to participate in a Web-based study about contraception. Those who clicked on the advertisement were directed to project information, and their eligibility was determined by using a screening survey. RESULTS: Our Facebook advertisement delivered 130,129 impressions, resulting in over 2000 clicks at an overall cost of Aus $918 (Aus $0.44 per click). Web-based project information was accessed by 493 women. Of these, 462 women completed the screening survey, and 437 (437/463, 95%) women were eligible. A total of 322 young women participated in Surveys 1 and 2 (74% response rate), and 284 women participated in Survey 3 (88% retention rate), with an advertising cost of Aus $2.85 per consenting participant. CONCLUSIONS: Facebook proved to be a quick, effective, and cost-efficient tool for recruiting young Australian women into a study that was investigating contraceptive preferences. However, Web-based recruitment may result in sociodemographic biases. Further research is required to evaluate whether Facebook is suitable for recruiting older study populations.