Social Acceptability of Health Behavior Posts on Social Media: An Experiment

Area of Science:

• Public Health
• Social Media Analysis
• Health Communication

Background:

• Social media platforms like X (formerly Twitter) are increasingly utilized for public health surveillance.
• Understanding social norms influencing health behavior posts is crucial for accurate data interpretation.
• Existing research has limited insight into the social acceptability of health behavior content shared online.

Purpose of the Study:

• To evaluate social norms related to posts about four key health behaviors (smoking, alcohol consumption, physical activity, eating) on X.
• To determine factors influencing the perceived social acceptability of health behavior disclosures on social media.
• To assess potential biases in using social media data for public health metrics.

Main Methods:

• A randomized web-based survey experiment involving 559 adult X users in Michigan, USA (2020-2022).
• Participants rated the social acceptability of 24 manipulated posts concerning four health behaviors.
• Statistical analyses included principal component analysis and linear mixed models with Benjamini-Hochberg correction.

Main Results:

• Posts depicting healthier and less stigmatized behaviors were rated as more socially acceptable.
• More educated participants found posts about unhealthy and stigmatized behaviors less acceptable.
• Posts about shared activities and expressions of liking were more acceptable than solitary or disliked activities.

Conclusions:

• Perceived social acceptability of health behavior posts may influence their frequency and content.
• Researchers using social media data for health behavior prevalence estimates must consider biases related to social acceptability.
• Findings highlight the need to account for social norms when interpreting online health discussions.