High User Engagement Research Articles

Feasibility, engagement, and preliminary clinical outcomes of a digital biodata-driven intervention for anxiety and depression.

HypothesisThe main hypothesis is that a digital, biodata-driven, and personalized program would exhibit high user retention and engagement, followed by more effective management of their depressive and anxiety symptoms.ObjectiveThis pilot study explores the feasibility, acceptability, engagement, and potential impact on depressive and anxiety and quality of life outcomes of the 16-week Feel Program. Additionally, it examines potential correlations between engagement and impact on mental health outcomes.MethodsThis single-arm study included 48 adult participants with mild or moderate depressive or anxiety symptoms who joined the 16-week Feel Program, a remote biodata-driven mental health support program created by Feel Therapeutics. The program uses a combination of evidence-based approaches and psychophysiological data. Candidates completed an online demographics and eligibility survey before enrolment. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire and Generalized Anxiety Disorder Scale, respectively. The Satisfaction with Life Scale and the Life Satisfaction Questionnaire were used to assess quality of life. User feedback surveys were employed to evaluate user experience and acceptability.ResultsIn total, 31 participants completed the program with an overall retention rate of 65%. Completed participants spent 60 min in the app, completed 13 Mental Health Actions, including 5 Mental Health Exercises and 4.9 emotion logs on a weekly basis. On average, 96% of the completed participants were active and 76.8% of them were engaged with the sensor during the week. Sixty five percent of participants reported very or extremely high satisfaction, while 4 out of 5 were very likely to recommend the program to someone. Additionally, 93.5% of participants presented a decrease in at least one of the depressive or anxiety symptoms, with 51.6 and 45% of participants showing clinically significant improvement, respectively. Finally, our findings suggest increased symptom improvement for participants with higher engagement throughout the program.ConclusionsThe findings suggest that the Feel Program may be feasible, acceptable, and valuable for adults with mild or moderate depressive and/or anxiety symptoms. However, controlled trials with bigger sample size, inclusion of a control group, and more diverse participant profiles are required in order to provide further evidence of clinical efficacy.

E-cigarette brands and social media influencers on Instagram: a social network analysis

BackgroundExposure to visual posts featuring e-cigarette products on social media is associated with increased e-cigarette use among US adolescents. Instagram is the largest source of e-cigarette social media marketing, where...

An Empirical Evaluation of Asymmetric Synchronous Collaboration Combining Immersive and Non-Immersive Interfaces Within the Context of Immersive Analytics

Collaboration is an essential part of data analysis, allowing multiple users to combine their expertise and to debate about the interpretation of data discoveries using their contextual knowledge. The design of collaborative interfaces within the context of Immersive Analytics remains challenging, particularly due to the various user-centered characteristics of immersive technologies. In this article, we present the use case of a system that enables multiple users to synchronously explore the same data in a collaborative scenario that combines immersive and non-immersive interfaces in an asymmetric role setup. Such a setup allows for bridging the gap when applying heterogeneous display and interaction technologies, enabling each analyst to have an independent and different view of the data, while maintaining important collaborative aspects during the joint data exploration. We developed an immersive VR environment (head-mounted display, 3D gestural input) and a non-immersive desktop terminal (monitor, keyboard and mouse) centered around spatio-temporal data exploration. Supported through a real-time communication interface, synchronous collaborative features are integrated in both interfaces, facilitating the users in their ability to establish a shared context and to make spatio-temporal references. We conducted an empirical evaluation with five participant pairs (within-subject design) to investigate aspects of usability, user engagement, and collaboration during a confirmative analysis task. Synthesis of questionnaire results in combination with additional log file analysis, audio activity analysis, and observations, revealed good usability scores, high user engagement, as well as overall close and balanced collaboration of enthusiastic pairs during the task completion independent of their interface type, validating our system approach in general. Further supported through the self-constructed Spatio-Temporal Collaboration Questionnaire, we are able to contribute with discussion and considerations of the presented scenario and the synchronous collaborative features for the design of similar applications.

Analyze the usage of urban greenways through social media images and computer vision

Urban greenway is an emerging form of urban landscape offering multifaceted benefits to public health, economy, and ecology. However, the usage and user experiences of greenways are often challenging to measure because it is costly to survey such large areas. Based on the online postings from Instagram in 2017, this paper used Computer Vision (CV) technology to analyze and compare how the general public uses two typical greenway parks, The High Line in New York City and the Atlanta Beltline in Atlanta. Face and object detection analysis were conducted to infer user composition, activities, and key experiences. We presented the temporal patterns of Instagram postings as well as the group gatherings, smiling, and representative objects detected from photos. Our results have shown high user engagement levels for both parks while teens are significantly underrepresented. The High Line had more group activities and was more active during weekdays than the Atlanta Beltline. Stronger sense of escape and physical activities can be found in Atlanta Beltline. In summary, social media images like Instagram can provide strong empirical evidence for urban greenway usage when combined with artificial intelligence technologies, which can support the future practice of landscape architecture and urban design.

Characteristics of and User Engagement With Antivaping Posts on Instagram: Observational Study.

BackgroundAlthough government agencies acknowledge that messages about the adverse health effects of e-cigarette use should be promoted on social media, effectively delivering those health messages is challenging. Instagram is one of the most popular social media platforms among US youth and young adults, and it has been used to educate the public about the potential harm of vaping through antivaping posts.ObjectiveWe aim to analyze the characteristics of and user engagement with antivaping posts on Instagram to inform future message development and information delivery.MethodsA total of 11,322 Instagram posts were collected from November 18, 2019, to January 2, 2020, by using antivaping hashtags including #novape, #novaping, #stopvaping, #dontvape, #antivaping, #quitvaping, #antivape, #stopjuuling, #dontvapeonthepizza, and #escapethevape. Among those posts, 1025 posts were randomly selected and 500 antivaping posts were further identified by hand coding. The image type, image content, and account type of antivaping posts were hand coded, the text information in the caption was explored by topic modeling, and the user engagement of each category was compared.ResultsAnalyses found that antivaping images of the educational/warning type were the most common (253/500; 50.6%). The average likes of the educational/warning type (15 likes/post) were significantly lower than the catchphrase image type (these emphasized a slogan such as “athletesdontvape” in the image; 32.5 likes/post; P<.001). The majority of the antivaping posts contained the image content element text (n=332, 66.4%), followed by the image content element people/person (n=110, 22%). The images containing people/person elements (32.8 likes/post) had more likes than the images containing other elements (13.8-21.1 likes/post). The captions of the antivaping Instagram posts covered topics including “lung health,” “teen vaping,” “stop vaping,” and “vaping death cases.” Among the 500 antivaping Instagram posts, while most posts were from the antivaping community (n=177, 35.4%) and personal account types (n=182, 36.4%), the antivaping community account type had the highest average number of posts (1.69 posts/account). However, there was no difference in the number of likes among different account types.ConclusionsMultiple features of antivaping Instagram posts may be related to user engagement and perception. This study identified the critical elements associated with high user engagement, which could be used to design antivaping posts to deliver health-related information more efficiently.

A comparison of patient testimonials on YouTube of the most common orthodontic treatment modalities: Braces, in-office aligners, and direct-to-consumer aligners

The aims of this study were to (1) investigate and compare the educational value of the most popular YouTube (www.youtube.com; Google, San Bruno, Calif) orthodontic patient testimonials between braces, in-office aligners (IOA), and direct-to-consumer aligners (DTCA), and (2) classify the emotional response of the viewers through sentiment analysis of the video comments. Three different phrases relevant to braces, IOA, and DTCA were searched on YouTube. The 20 most popular patient testimonial videos meeting the criteria for each group were selected for a total of 60 videos. Using the YouTube application program interface for each video, 13 video metrics were extracted. An information completeness score was assigned, and the video comments were analyzed using sentiment analysis software. The 60 videos included were viewed 34.4 million times by internet users. Braces videos had significantly more likes, comments, and a higher viewer interaction score than the IOA and DTCA videos. IOA videos had a higher median information completeness score than braces and DTCA videos. Of the 5149 video comments with polarity, 53.6% were positive, and 46.4% were negative (P<0.0001). There was no significant association between the treatment modality and positive or negative comments (P= 0.5679). There is high user engagement on YouTube with orthodontic patient testimonials. YouTube users interact with braces patient testimonials the most. YouTube viewers' comments on orthodontic patient testimonials express more positive sentiment than negative sentiment. There was no significant difference in positive and negative sentiment between the video comments for the 3 different treatment modalities.

The Limited Influence of Right-Wing Movements on Social Media User Engagement

This article generates new insights into the dynamic interplay between social media content generated by right-wing movements, user engagement, and the public attention movements receive. I argue that movement leaders seek to achieve high user engagement for utilizing mechanisms of information diffusion to increase both online and on-site mobilization. In a case study, I analyze the German right-wing movement Pegida, which uses Facebook for spreading its anti-Islam agenda online. Data from Pegida’s Facebook page are combined with news reports over a period of 18 months to measure activity on Facebook and in the public sphere simultaneously. Results of quantitative text and time series analysis show that Pegida cannot influence user engagement by simply creating more posts. Instead, it is the content of posts that matters. Moreover, findings highlight a strong connection between Facebook activities and the public sphere. In times of decreasing attention, the movement changes its social media strategy in response to exogenous shocks: Pegida resorts increasingly to radical mobilization methods by posting xenophobic content that is more likely to incite users to engage on Facebook.

COVID RADAR app: Description and validation of population surveillance of symptoms and behavior in relation to COVID-19.

Monitoring of symptoms and behavior may enable prediction of emerging COVID-19 hotspots. The COVID Radar smartphone app, active in the Netherlands, allows users to self-report symptoms, social distancing behaviors, and COVID-19 status daily. The objective of this study is to describe the validation of the COVID Radar. COVID Radar users are asked to complete a daily questionnaire consisting of 20 questions assessing their symptoms, social distancing behavior, and COVID-19 status. We describe the internal and external validation of symptoms, behavior, and both user-reported COVID-19 status and state-reported COVID-19 case numbers. Since April 2nd, 2020, over 6 million observations from over 250,000 users have been collected using the COVID Radar app. Almost 2,000 users reported having tested positive for SARS-CoV-2. Amongst users testing positive for SARS-CoV-2, the proportion of observations reporting symptoms was higher than that of the cohort as a whole in the week prior to a positive SARS-CoV-2 test. Likewise, users who tested positive for SARS-CoV-2 showed above average risk social-distancing behavior. Per-capita user-reported SARS-CoV-2 positive tests closely matched government-reported per-capita case counts in provinces with high user engagement. The COVID Radar app allows voluntarily self-reporting of COVID-19 related symptoms and social distancing behaviors. Symptoms and risk behavior increase prior to a positive SARS-CoV-2 test, and user-reported case counts match closely with nationally-reported case counts in regions with high user engagement. These results suggest the COVID Radar may be a valid instrument for future surveillance and potential predictive analytics to identify emerging hotspots.

Developing and Implementing an App-Based Blended Psychological Skills Training: A Case Study

The present case study describes the content and implementation of a blended psychological skills training, consisting of an app and workshops, with a group of athletes (N = 44) from a Bundesliga soccer academy in Germany. In a pre–post design, athletes completed different questionnaires at two measurement points. There was a significant increase in concentration and self-efficacy and more frequent recovery after the intervention. However, athletes showed equal competition anxiety levels and more frequent stress after the intervention. The app’s training time was brief (M = 14.36 min,SD = 18.17 min) over 9 weeks and did not moderate the intervention’s effects. A comparison between active users and nonusers indicates that the results found were due to the workshops. The qualitative feedback indicates that motivational functions should be added to a psychological skills training app and time slots should be created in athletes’ demanding schedules to ensure high user engagement.

Analysing tourism destination promotion through Facebook by Destination Marketing Organizations of India

ABSTRACT Today, the promotion of tourism destinations is evident through social media as tourists have become content creators and influencers. Destination Marketing Organizations (DMOs) promote destinations through various social media platforms of which Facebook, Twitter, and YouTube are common. Of these platforms, Facebook is widely used for promotion, consumer research, and customer service, which makes it the foremost choice of DMOs for destination promotion. In India, the State and Union Territory tourism departments act as DMOs. The study explores how Indian DMOs strategically employ Facebook to promote their destinations. Six months’ data were collected from the Facebook pages of 32 DMOs for content analysis. Semi-structured interviews were conducted with seven managers of tourism departments. The Jammu and Kashmir and Kerala DMOs have shown high user engagement through firm-generated content (visual content and informative posts). The findings conclude that DMOs are using Facebook as a supplement to traditional marketing tools and rarely for customer service and research. DMOs benefit from the contents of scenic beauty, culture, and cuisine which appeal more to engage users on Facebook pages. Further, implications for management and managerial actions have been suggested.

Avoiding Zoom Fatigue: The Uses and Gratifications on Social Media

The Corona Virus Disease 2019 (Covid-19) pandemic has forced the government to implement Large-Scale Social Restrictions (PSBB) several times. As a result of this policy, it is mandatory to implement the Working From Home (WFH) policy. The company then facilitates its employee with virtual meeting applications, such as Zoom. On the other hand, WFH has a frequent impact and the length of time spent in virtual meetings causes zoom fatigue. The purpose of this study is to determine the uses and gratification of social media users to avoid zoom fatigue when working from home during the Covid-19 pandemic. Social media users use it as a means of fulfilling usability and satisfaction based on the media chosen. This study will describe the uses and gratification of using social media during WFH to avoid “Zoom fatigue” based on Computer-Mediated Communication Theory and Uses and Gratification Theory.The study uses a qualitative approach with an explorative method to find or formulate problems from a phenomenon. The study uses literature studies based on scientific articles in international and national journals related to the use of social media based on the Uses and Gratification theory in the last ten years. For further exploration, the researcher conducted in-depth semi-structured interviews via email and telephone with three informants. The interview results revealed the uses and gratification for social media users to avoid zoom fatigue while undergoing WFH during the pandemic Covid-19. Social media as a source of entertainment and relaxation, a source of information, spending time, interacting and expressing opinions, and monitoring. The researcher hopes that the results of this study can fill the lack of existing research related to the uses and gratification of social media based on Computer-Mediated Communication and Uses and Gratification Theory. It can also contribute knowledge to practitioners who are content creators, marketing agencies, and online shop owners to optimize content to get high user engagement.

Digital content creation: an emerging role for librarians

Purpose The increasing importance of digital content creation in relation to content marketing and promotion of library and information services in the Fourth Industrial Revolution (4IR) has attracted global attention. Thus, the purpose of this study is to theoretically examine librarians’ role in the creation of digital content in the 4IR. Design/methodology/approach This study used the review method to theoretically examine the nexus between digital content creation and librarians’ role in the 4IR. Findings This study showed that librarians are well positioned to become professional digital content creation, as they already possess the basic skills needed to create effective content for high user engagement. Originality/value This study seeks to pioneer a new area of focus by linking librarians’ skills to digital content creation skills and making a case for librarians as the perfect digital content creator.

User-Engagement Score and SLIs/SLOs/SLAs Measurements Correlation of E-Business Projects Through Big Data Analysis

The Covid-19 crisis lockdown caused rapid transformation to remote working/learning modes and the need for e-commerce-, web-education-related projects development, and maintenance. However, an increase in internet traffic has a direct impact on infrastructure and software performance. We study the problem of accurate and quick web-project infrastructure issues/bottleneck/overload identification. The research aims to achieve and ensure the reliability and availability of a commerce/educational web project by providing system observability and Site Reliability Engineering (SRE) methods. In this research, we propose methods for technical condition assessment by applying the correlation of user-engagement score and Service Level Indicators (SLIs)/Service Level Objectives (SLOs)/Service Level Agreements (SLAs) measurements to identify user satisfaction types along with the infrastructure state. Our solution helps to improve content quality and, mainly, detect abnormal system behavior and poor infrastructure conditions. A straightforward interpretation of potential performance bottlenecks and vulnerabilities is achieved with the developed contingency table and correlation matrix for that purpose. We identify big data and system logs and metrics as the central sources that have performance issues during web-project usage. Throughout the analysis of an educational platform dataset, we found the main features of web-project content that have high user-engagement and provide value to services’ customers. According to our study, the usage and correlation of SLOs/SLAs with other critical metrics, such as user satisfaction or engagement improves early indication of potential system issues and avoids having users face them. These findings correspond to the concepts of SRE that focus on maintaining high service availability.

Challenges in Acceptance and Compliance in Digital Health Assessments During Pregnancy: Prospective Cohort Study.

BackgroundPregnant women are increasingly using mobile apps to access health information during the antenatal period. Therefore, digital health solutions can potentially be used as monitoring instruments during pregnancy. However, a main factor of success is high user engagement.ObjectiveThe aim of this study was to analyze engagement and factors influencing compliance in a longitudinal study targeting pregnant women using a digital health app with self-tracking.MethodsDigitally collected data concerning demographics, medical history, technical aspects, and mental health from 585 pregnant women were analyzed. Patients filling out ≥80% of items at every study visit were considered to be highly compliant. Factors associated with high compliance were identified using logistic regression. The effect of a change in mental and physical well-being on compliance was assessed using a one-sample t test.ResultsOnly 25% of patients could be considered compliant. Overall, 63% left at least one visit blank. Influential variables for higher engagement included higher education, higher income, private health insurance, nonsmoking, and German origin. There was no relationship between a change in the number of physical complaints or depressive symptoms and study dropout.ConclusionsMaintaining high engagement with digital monitoring devices over a long time remains challenging. As cultural and socioeconomic background factors had the strongest influence, more effort needs to be directed toward understanding the needs of patients from different demographic backgrounds to ensure high-quality care for all patients. More studies need to report on compliance to disclose potential demographic bias.

Data analytics of social media publicity to enhance household waste management

Household waste segregation and recycling is ranked at a high priority of the waste management hierarchy. Its management remains a great challenge due to the high dependency on social behaviours. The integration of Internet of Things (IoT) and subscription accounts on social media platforms related to household waste management could be an effective and environmentally friendly publicity approach than traditional publicity via posters and newspapers. However, there is a paucity of literature on measuring social media publicity in household waste management, which brings challenges for practitioners to characterise and improve this publicity pathway. In this study, under an integrated framework, data mining approaches are employed or extended for multidimensional publicity analytics using the data of online footprints of propagandist and users. A real-world case study based on a subscription account on the WeChat platform, Shanghai Green Account, is analysed to reveal useful insights for personalised improvements of household waste management. This study suggests that the current publicity related to household waste management leans towards propagandist-centred in both timing and topic dimensions. The identified timing, which has high user engagement, is 12:00–13:00 and 21:00–22:00 on Thursday. The overall relative publicity quality of historical posts is calculated as 0.95. Average user engagement under the macro policy in Shanghai was elevated by 138.5% from 2018 to 2019, during which the collections of biodegradable food waste and recyclable waste were elevated by 88.8% and 431.8%. Intelligent decision support by publicity analytics could enhance household waste management through effective communication.

Qualitative Synthesis of Young People's Experiences With Technology-Assisted Cognitive Behavioral Therapy: Systematic Review.

BackgroundCognitive behavioral therapy (CBT) for young people is increasingly being provided using technology-assisted formats. Although there is increasing evidence regarding the efficacy of such approaches, as illustrated by quantitative systematic reviews, the literature has also highlighted challenges with implementation factors, including high attrition rates and variable user engagement. Qualitative review methods can help to address the factors that impact young peoples’ experience of technology-assisted cognitive behavioral therapy (tech-assisted CBT) and, thus, enable us to better understand such implementation factors. To date, no such qualitative synthesis exists.ObjectiveThe primary aim of this review was to systematically identify and synthesize the qualitative literature concerning the experiences of young people who have used tech-assisted CBT.MethodsThis systematic review applied Thomas and Harden’s 2008 qualitative thematic synthesis approach. This involved line-by-line coding of the results sections of included studies and an inductive analysis on identified themes, followed by the generation of analytical themes through a process of iteration and interpretation of the descriptive themes. PsycINFO, ACM Digital Library, PubMed, EMBASE, and JMIR Publications databases were searched. The inclusion criteria were (1) studies involving school-aged young people over preschool age (6 years) but under the age of 18 years, (2) use of any form of tech-assisted CBT for any time period, (3) a stated focus of qualitative data to document the experiences of participants, and (4) studies published in English. The exclusion criteria were (1) interventions only provided face-to-face with no technological component, (2) only focused on the performance of the technology rather than participant experience, and (3) numerical data that sought to represent qualitative data.ResultsA total of 14 studies were included in this review. Overall, these studies represented interventions for low mood and anxiety (n=10), trauma or self-harm (n=2), and physical difficulties (n=2). Overall, 5 analytical themes emerged on young people’s experiences with tech-assisted CBT: (1) helpfulness, (2) therapeutic process, (3) transferability, (4) gameplay experience, and (5) limitations. In addition, these analytical themes contained the following subthemes: positive experiences, tech-assisted CBT versus face-to-face CBT, understanding of a CBT model, process of change, skills development, application to everyday life settings, parental involvement, character relatedness, playability, negative experiences, and broad content.ConclusionsOverall, young people’s experiences with tech-assisted CBT were mostly positive. The use of gaming environments, relatable characters, concrete metaphors, and age-appropriate narratives contributed to these positive experiences. Evidence suggests that technology can help to mediate face-to-face relationships with therapists and help young people to understand the CBT model. Clear barriers also emerged, including over-reliance on reading and writing skills and dissatisfaction with overly generalized content and comparison with commercial technologies.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42018103388; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018103388

Smartphone Apps to Support Coordinated Specialty Care for Prodromal and Early Course Schizophrenia Disorders: Systematic Review.

BackgroundDemand for mental health services, especially for clinical high-risk and early psychosis, has increased, creating a need for new solutions to increase access to and quality of care. Smartphones and mobile technology are potential tools to support coordinated specialty care for early psychosis, given their potential to augment the six core roles of care: case management and team leadership, recovery-oriented psychotherapy, medication management, support for employment and education, coordination with primary care services, and family education and support. However, the services smartphones are actually offering specifically for coordinated specialty care and the level of evidence are unknown.ObjectiveThis study aimed to review the published literature on smartphone technology to enhance care for patients with prodromal and early course psychosis and schizophrenia and to analyze studies by type, aligned with coordinated specialty care domains.MethodsA systematic literature search was conducted on August 16 and 17, 2019, using the PubMed, EMBASE, Web of Sciences, and PsycINFO electronic databases. The eligible studies were reviewed and screened based on inclusion and exclusion criteria.ResultsThe search uncovered 388 unique results, of which 32 articles met the initial inclusion criteria; 21 eligible studies on 16 unique app platforms were identified. Feasibility studies showed a high user engagement and interest among patients, monitoring studies demonstrated a correlation between app assessments and clinical outcomes, and intervention studies indicated that these apps have the potential to advance care. Eighteen studies reported on app use for the case management roles of coordinated specialty care. No app studies focused on employment and education, coordination with primary care services, and family education and support.ConclusionsAlthough the published literature on smartphone apps for prodromal and first-episode psychosis is small, it is growing exponentially and holds promise to augment both monitoring and interventions. Although the research results and protocols for app studies are not well aligned with all coordinated specialty care roles today, high rates of adoption and feasibility suggest the potential for future efforts. These results will be used to develop coordinated specialty care–specific app evaluation scales and toolkits.

419. Initial Evaluation of Engagement and Utilization of the National Sexually Transmitted Diseases Curriculum

BackgroundThe National Sexually Transmitted Diseases Curriculum (NSTDC) is an online, guideline-based, interactive curriculum developed at the University of Washington in Seattle with funding from the Centers for Disease Control and Prevention (CDC) National Network of STD Clinical Prevention Training Centers (NNPTC). The NSTDC has dual-functionality to provide users with the option of engaging in (1) sequential, longitudinal learning and/or (2) quick access to specific content. We describe the first evaluation of the reach, utilization and effectiveness of the NSTDC.MethodsWe evaluated user data collected from survey completion, Google Analytics, and the Health Professional Application for Training (HPAT) between the launch of NSTDC in February 1, 2017 through August 31, 2018. Chi-square and ANOVA tests were used to determine significant differences between prescribers, nurses, and non-clinicians.Resultsmonth period and 54,910 hours of CE awarded. Registered users were mostly women (16,133, 84%), and 8,476 (44%) were registered nurses, with an additional 6,052 (34%) prescribing providers (physicians, nurse practitioners, physician assistants, and dentists). The most common programmatic focus was primary care (4,886, 25%). While 18,175 (95%) of users were in the United States, users were located around the world (Figure 1). Referral patterns differed significantly by occupation (Figure 2). Users engaged deeply with the curriculum. Average site session time was 28 minutes for registered users and 14 minutes for all users. Registered users completed an average of 4.37 out of 7 total modules. Nurses were more likely to complete all modules, (48% vs. 34% of prescribers and 30% of non-clinicians, P < 0.0001). Over 15,000 users answered at least one optional check-on-learning (COL) question. On average, 77% of COL questions were answered in modules where COL questions were initiated. Over 60% of the users found the content and experience highly satisfying. Overall 39% of users intended to change practice following completion of the modules.ConclusionThe NSTDC has a broad reach, leads to high user engagement and satisfaction, and fosters intent to change practice. This web-based curriculum is a novel and effective strategy to disseminate recommendations from CDC Guidelines. Disclosures All authors: No reported disclosures.

Alcohol Advertising on Facebook and the Desire to Drink Among Young Adults

Social networking sites (SNSs) may influence the behavior of SNS users by exposing them to information about the number of other users who engaged with a SNS post (i.e., user engagement) and any comments left in response to a post (i.e., user-generated comments [UGCs]). The current study hypothesized that beer advertisements with higher user engagement levels and pro-drinking UGCs would be positively associated with the desire to drink and ad engagement. The effect of ad content in relation to regulatory compliance was also investigated. A 2 (regulatory compliant vs. noncompliant) × 2 (low vs. high user engagement) × 2 (pro- vs. anti-alcohol UGC) mixed factorial experiment was used. A total of 120 young adults viewed two compliant and two noncompliant ads. Participants were randomized into four groups: ads with high or low user engagement values, which were paired with either pro- or anti-drinking UGCs. Dependent variables included desire to drink and engaging (i.e., Liking or Sharing) with the ad. When associated with high user engagement values, the desire to drink was 3.5 times greater in the pro-drinking UGC group compared with the anti-drinking UGC group (odds ratio = 3.48, 95% CI [1.60, 7.55]). Ad engagement was 2.3 times greater among those exposed to pro-drinking UGCs (odds ratio = 2.30, 95% CI [1.09, 4.85]). Pro-drinking comments may increase the desire to drink and ad engagement, both of which may be predictive of future drinking behavior. Regulations are needed to limit the ability of SNS users to engage with alcohol ads.

Advertising Content, Platform Characteristics and the Appeal of Beer Advertising on a Social Networking Site

The current study was conducted to investigate how changes in the content of a social media ad, user engagement values associated with the ad and user-generated comments (UGCs) associated with the ad can influence the appeal (i.e. source appeal, informational appeal and emotional appeal) of a social media ad. Facebook beer ads that violated the guidelines of a relevant marketing code were rated as more emotionally appealing compared to Facebook beer ads that did not violated the guidelines. Increased emotional appeal in beer advertising increases the probability that the ad will be remembered and influence future drinking occasions. A 2 (ad regulatory compliance: compliant vs. non-compliant) × 2 (user engagement: low vs. high) × 2 (UGC congruence: pro- vs anti-alcohol) mixed factorial experiment was conducted with 120 young adults, 21-24 years old. Each participant viewed four Facebook beer ads that were previously evaluated for thematic content and regulatory compliance. Participants were randomized to view either high or low user engagement values and either pro- or anti-drinking user-generated comments. After each ad exposure, ad appeal was assessed. Statistical analysis was conducted using hierarchical linear modeling. Models were adjusted for demographics, Alcohol Use Disorders Identification Test (AUDIT) scores and Facebook involvement. Source appeal (P = 0.034) and informational appeal (P < 0.001) were significantly higher among ads that were compliant with existing advertising regulations. Emotional appeal was significantly higher among ads that were non-compliant (P = 0.004). The effect of user engagement and UGCs were non-significant (p's > 0.05). Additionally, AUDIT scores (p's < 0.01) and Facebook involvement scores (p's < 0.01) were positively associated with all forms of ad appeal. The appeal of Facebook beer ads may be primarily determined by ad content. Increased emotional appeal in advertising caused by non-compliant advertising may increase the probability that the ad will be remembered and influence future drinking occasions.