Introduction Social media has created opportunities for children to gather social support online (Blackwell et al., 2016; Gonzales, 2017; Jackson, Bailey, & Foucault Welles, 2018; Khasawneh, Rogers, Bertrand, Madathil, & Gramopadhye, 2019; Ponathil, Agnisarman, Khasawneh, Narasimha, & Madathil, 2017). However, social media also has the potential to expose children and adolescents to undesirable behaviors. Research showed that social media can be used to harass, discriminate (Fritz & Gonzales, 2018), dox (Wood, Rose, & Thompson, 2018), and socially disenfranchise children (Page, Wisniewski, Knijnenburg, & Namara, 2018). Other research proposes that social media use might be correlated to the significant increase in suicide rates and depressive symptoms among children and adolescents in the past ten years (Mitchell, Wells, Priebe, & Ybarra, 2014). Evidence based research suggests that suicidal and unwanted behaviors can be promulgated through social contagion effects, which model, normalize, and reinforce self-harming behavior (Hilton, 2017). These harmful behaviors and social contagion effects may occur more frequently through repetitive exposure and modelling via social media, especially when such content goes “viral” (Hilton, 2017). One example of viral self-harming behavior that has generated significant media attention is the Blue Whale Challenge (BWC). The hearsay about this challenge is that individuals at all ages are persuaded to participate in self-harm and eventually kill themselves (Mukhra, Baryah, Krishan, & Kanchan, 2017). Research is needed specifically concerning BWC ethical concerns, the effects the game may have on teenagers, and potential governmental interventions. To address this gap in the literature, the current study uses qualitative and content analysis research techniques to illustrate the risk of self-harm and suicide contagion through the portrayal of BWC on YouTube and Twitter Posts. The purpose of this study is to analyze the portrayal of BWC on YouTube and Twitter in order to identify the themes that are presented on YouTube and Twitter posts that share and discuss BWC. In addition, we want to explore to what extent are YouTube videos compliant with safe and effective suicide messaging guidelines proposed by the Suicide Prevention Resource Center (SPRC). Method Two social media websites were used to gather the data: 60 videos and 1,112 comments from YouTube and 150 posts from Twitter. The common themes of the YouTube videos, comments on those videos, and the Twitter posts were identified using grounded, thematic content analysis on the collected data (Padgett, 2001). Three codebooks were built, one for each type of data. The data for each site were analyzed, and the common themes were identified. A deductive coding analysis was conducted on the YouTube videos based on the nine SPRC safe and effective messaging guidelines (Suicide Prevention Resource Center, 2006). The analysis explored the number of videos that violated these guidelines and which guidelines were violated the most. The inter-rater reliabilities between the coders ranged from 0.61 – 0.81 based on Cohen’s kappa. Then the coders conducted consensus coding. Results & Findings Three common themes were identified among all the posts in the three social media platforms included in this study. The first theme included posts where social media users were trying to raise awareness and warning parents about this dangerous phenomenon in order to reduce the risk of any potential participation in BWC. This was the most common theme in the videos and posts. Additionally, the posts claimed that there are more than 100 people who have played BWC worldwide and provided detailed description of what each individual did while playing the game. These videos also described the tasks and different names of the game. Only few videos provided recommendations to teenagers who might be playing or thinking of playing the game and fewer videos mentioned that the provided statistics were not confirmed by reliable sources. The second theme included posts of people that either criticized the teenagers who participated in BWC or made fun of them for a couple of reasons: they agreed with the purpose of BWC of “cleaning the society of people with mental issues,” or they misunderstood why teenagers participate in these kind of challenges, such as thinking they mainly participate due to peer pressure or to “show off”. The last theme we identified was that most of these users tend to speak in detail about someone who already participated in BWC. These videos and posts provided information about their demographics and interviews with their parents or acquaintances, who also provide more details about the participant’s personal life. The evaluation of the videos based on the SPRC safe messaging guidelines showed that 37% of the YouTube videos met fewer than 3 of the 9 safe messaging guidelines. Around 50% of them met only 4 to 6 of the guidelines, while the remaining 13% met 7 or more of the guidelines. Discussion This study is the first to systematically investigate the quality, portrayal, and reach of BWC on social media. Based on our findings from the emerging themes and the evaluation of the SPRC safe messaging guidelines we suggest that these videos could contribute to the spread of these deadly challenges (or suicide in general since the game might be a hoax) instead of raising awareness. Our suggestion is parallel with similar studies conducted on the portrait of suicide in traditional media (Fekete & Macsai, 1990; Fekete & Schmidtke, 1995). Most posts on social media romanticized people who have died by following this challenge, and younger vulnerable teens may see the victims as role models, leading them to end their lives in the same way (Fekete & Schmidtke, 1995). The videos presented statistics about the number of suicides believed to be related to this challenge in a way that made suicide seem common (Cialdini, 2003). In addition, the videos presented extensive personal information about the people who have died by suicide while playing the BWC. These videos also provided detailed descriptions of the final task, including pictures of self-harm, material that may encourage vulnerable teens to consider ending their lives and provide them with methods on how to do so (Fekete & Macsai, 1990). On the other hand, these videos both failed to emphasize prevention by highlighting effective treatments for mental health problems and failed to encourage teenagers with mental health problems to seek help and providing information on where to find it. YouTube and Twitter are capable of influencing a large number of teenagers (Khasawneh, Ponathil, Firat Ozkan, & Chalil Madathil, 2018; Pater & Mynatt, 2017). We suggest that it is urgent to monitor social media posts related to BWC and similar self-harm challenges (e.g., the Momo Challenge). Additionally, the SPRC should properly educate social media users, particularly those with more influence (e.g., celebrities) on elements that boost negative contagion effects. While the veracity of these challenges is doubted by some, posting about the challenges in unsafe manners can contribute to contagion regardless of the challlenges’ true nature.
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Classification of Health-Related Social Media Posts: Evaluation of Post Content–Classifier Models and Analysis of User Demographics
Background The increasing volume of health-related social media activity, where users connect, collaborate, and engage, has increased the significance of analyzing how people use health-related social media. Objective The aim of this study was to classify the content (eg, posts that share experiences and seek support) of users who write health-related social media posts and study the effect of user demographics on post content. Methods We analyzed two different types of health-related social media: (1) health-related online forums—WebMD and DailyStrength—and (2) general online social networks—Twitter and Google+. We identified several categories of post content and built classifiers to automatically detect these categories. These classifiers were used to study the distribution of categories for various demographic groups. Results We achieved an accuracy of at least 84% and a balanced accuracy of at least 0.81 for half of the post content categories in our experiments. In addition, 70.04% (4741/6769) of posts by male WebMD users asked for advice, and male users’ WebMD posts were more likely to ask for medical advice than female users’ posts. The majority of posts on DailyStrength shared experiences, regardless of the gender, age group, or location of their authors. Furthermore, health-related posts on Twitter and Google+ were used to share experiences less frequently than posts on WebMD and DailyStrength. Conclusions We studied and analyzed the content of health-related social media posts. Our results can guide health advocates and researchers to better target patient populations based on the application type. Given a research question or an outreach goal, our results can be used to choose the best online forums to answer the question or disseminate a message.
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- Award ID(s):
- 1901379
- NSF-PAR ID:
- 10161340
- Date Published:
- Journal Name:
- JMIR Public Health and Surveillance
- Volume:
- 6
- Issue:
- 2
- ISSN:
- 2369-2960
- Page Range / eLocation ID:
- e14952
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.2196/14952
