Secret Facebook Group Research Articles

What do spouse primary caregivers of patients with glioblastoma want medical providers to know? A qualitative thematic reflexive analysis of letters written by primary caregivers from a secret Facebook support group

ObjectivesTo analyse the content of letters written by female spouse primary caregivers of patients with glioblastoma multiforme (GBM), a devastating and terminal primary brain cancer, and give voice to their...

Acceptability, feasibility and potential of an intervention using secret Facebook groups to complement existing HIV prevention strategies among female sex workers in Cameroon, a randomized pilot study

ABSTRACT This randomized pilot project evaluated an intervention promoting health care literacy around HIV, pre-exposure prophylaxis (PrEP), and stigma reduction using private social media groups that complemented existing HIV prevention services among female sex workers (FSWs) in Cameroon. The intervention was 12 HIV and sexual health videos tailored to FSWs that were released over 8 weeks through a secret Facebook group platform. In-person surveys were administered before, after the intervention, and three months later. No HIV seroconversions were detected; all participants completed follow-up and agreed to recommend the intervention to a coworker. Although the intervention was assessed to be acceptable and feasible to implement, poor internet connectivity was a key barrier. In time-series analysis, the intervention group participants reported improved PrEP interest, PrEP knowledge, and condom use along with reduced PrEP and HIV-related stigma, but no impact on sex-work related stigma or social cohesion. Similar results occurred in the control group. Cross-contamination and small pilot study size might have hindered the ability to detect the differential impact of this intervention. As communications technology increases in Cameroon, it is essential to learn more about FSWs preferences on the use of social media platforms for HIV prevention strategies.

Social media interventions addressing physical activity among emerging adults who use cannabis: A pilot trial of feasibility and acceptability

PurposeCannabis use is common among emerging adults (ages 18–25), yet few prevention interventions have targeted this unique developmental period. Physical activity (PA) is an under-utilized intervention target for cannabis use, despite research showing its potential utility. Based on prior promising social media-delivered interventions targeting cannabis and PA separately, we developed and piloted, in a randomized controlled feasibility trial (NCT 04901910), interventions for emerging adults who use cannabis that focused on PA. ProceduresUsing social media, we recruited 60 emerging adults (Mean age=21.7 years; 63.3% female sex) who used cannabis (>=3 times/week for the past month) and could engage in PA. We randomized participants into one of 3 conditions (PA-Only; PA+Cannabis, Attention-Control) that each lasted 8 weeks and were delivered in secret Facebook groups by health coaches. We collected follow-up data at 3- and 6-months post-group start. Outcomes are presented descriptively given the pilot nature and limited sample size. ResultsThe interventions were rated favorably, with ratings of the content in each condition averaging around 3 on a 5-point scale. Both intervention groups demonstrated larger reductions in cannabis consequences and cannabis-impaired driving over time than the control condition. Findings were mixed regarding patterns of change in cannabis use in the intervention conditions. Proportions of group members reporting increased PA ranged from 38.9% to 80.0% across time. ConclusionsInterventions targeting PA and delivered via social media to emerging adults who regularly use cannabis offer a novel intervention target. These interventions warrant future investigation in larger trials over a longer follow-up period.

A randomized controlled trial of social media interventions for risky drinking among adolescents and emerging adults

PurposeAlcohol use among adolescents and emerging adults is an important public health issue requiring prevention approaches. Herein, we describe outcomes from a randomized controlled trial testing the efficacy of group-based social media interventions targeting risky drinking among youth. ProceduresUsing social media advertisements to screen potential participants, we recruited 955 youth (ages 16–24) reporting recent risky drinking. After completing a baseline assessment, participants were randomized to 8-week secret Facebook group conditions: Social Media Intervention + Incentives for engagement, Social Media Intervention only, and attention-placebo control. Electronic coaches trained in motivational interviewing facilitated interaction in intervention groups. Primary outcomes include past 3-month alcohol use and consequences over 3-, 6-, and 12-month follow-ups. Secondary outcomes include other drug use, consequences, and impaired driving. We also measured intervention engagement and acceptability. ResultsThe interventions were well-received, with significantly greater acceptability ratings and engagement in the SMI+I condition relative to other groups. In adjusted analyses, there were no significant differences between interventions and control on alcohol-related outcomes, with all groups showing reductions. Regarding secondary outcomes (70.4% used other drugs), compared to control, the incentivized group reduced other drug use, consequences, and cannabis-impaired driving; the non-incentivized group did not significantly differ from the control condition. ConclusionsAmong this predominantly poly-substance using sample, findings were mixed, with significant effects of the incentivized social media intervention on drug (but not alcohol) outcomes. Future studies are needed to further refine social media-delivered interventions to reduce alcohol and other drug use.Trial Registration: ClinicalTrials.gov NCT02809586; University of Michigan HUM#00102242.

A social media intervention for cannabis use among emerging adults: Randomized controlled trial

PurposeCannabis use is increasing among emerging adults (ages 18–25), necessitating the need for prevention interventions. Using a novel platform – social media – we developed an 8-week motivational interviewing and cognitive-behavioral intervention targeting cannabis use among emerging adults. Herein, we report on the feasibility and acceptability of the intervention in a pilot trial. ProceduresFor NCT 04187989 we recruited N = 149 emerging adults who used cannabis (at least 3 times/week for the past month) using social media advertising. Their mean age was 21.0 years (SD = 2.2); 55.7% were female. Most were White (70.5%; 20.1% Black/African American, 9.4% Other races), with 20.1% identifying as Hispanic/Latinx. Participants were randomized to the 8-week intervention or an 8-week attention-placebo control condition, both delivered in secret Facebook groups by electronic health coaches (e-coaches). Follow-up assessments occurred at 3- and 6-months. ResultsThe intervention was well-received and follow-up rates were high; fidelity was good. Intervention participants rated e-coaches significantly higher in terms of helpfulness, warmth, etc., compared to control participants. Intervention participants were more likely to engage with and recommend the group. In terms of percentage reductions in cannabis outcomes, the intervention group evidenced absolute reductions over time in several measures of cannabis consumption across modalities. In an adjusted model, reductions in vaping days in the intervention group, relative to attention-control, reached statistical significance (p = .020, D =.40). ConclusionsThis social media intervention for emerging adults’ cannabis use was feasible and acceptable in the target population warranting future testing in a fully powered trial.

The miscarriage circle of care: towards leveraging online spaces for social support

BackgroundLack of social support during and after miscarriage can greatly affect mental wellbeing. With miscarriages being a common experience, there remains a discrepancy in the social support received after a pregnancy is lost.Method42 people who had experienced at least one miscarriage took part in an Asynchronous Remote Community (ARC) study. The study involved 16 activities (discussions, creative tasks, and surveys) in two closed, secret Facebook groups over eight weeks. Descriptive statistics were used to analyse quantitative data, and content analysis was used for qualitative data.ResultsThere were two main miscarriage care networks, formal (health care providers) and informal (friends, family, work colleagues). The formal care network was the most trusted informational support source, while the informal care network was the main source of tangible support. However, often, participants’ care networks were unable to provide sufficient informational, emotional, esteem, and network support. Peers who also had experienced miscarriage played a crucial role in addressing these gaps in social support. Technology use varied greatly, with smartphone use as the only common denominator. While there was a range of online support sources, participants tended to focus on only a few, and there was no single common preferred source.DiscussionWe propose a Miscarriage Circle of Care Model (MCCM), with peer advisors playing a central role in improving communication channels and social support provision. We show how the MCCM can be used to identify gaps in service provision and opportunities where technology can be leveraged to fill those gaps.

865. Social Media Secret Facebook Groups for HIV Pre-Exposure Prophylaxis Awareness among Female Sex Workers in Cameroon

BackgroundAbout 25% of Cameroonian female sex workers (FSW) lived with HIV in 2018. PrEP was introduced in Cameroon in 2019, with minimal uptake as of 2021. The goal of this pilot project was to evaluate the potential of a novel social media intervention to raise Pre-Exposure Prophylaxis (PrEP) awareness and complement HIV prevention strategies among FSW, a key risk population.MethodsFrom October 2020 to April 2021, sixty adult HIV-negative FSW who owned a phone with internet access joined the study; 40 in the intervention arm and 20 in the control arm. The intervention had a Secret Facebook Group (SFG) platform for confidentiality. It included 12 videos on HIV prevention in the local dialect, released over 8 weeks. In-person surveys were administered before and after the intervention, and three months later. Likert scale was used to evaluate the main outcome: PrEP awareness. Data was analyzed using Stata IC/version 14.2.ResultsDemographic characteristics were similar between intervention and control groups for age (29 years, SD7.3), literacy (45% secondary school), parity (1.9, SD1.5), and years as sex worker (7.8, SD5.1). One FSW had heard about PrEP before the intervention. After a brief introduction, 39% (15/38) of FSW in the intervention group and 50% (10/20) in the control group strongly agreed to be interested in taking PrEP (p=0.2). Baseline PrEP knowledge was poor in the intervention group (15/40, 38%) and very poor in the control group (19/20,95%) (p=0.0001). In the second survey, the intervention and control groups’ PrEP knowledge improved (p=0.0001 and p=0.02, respectively). It was more significant in the intervention group, with all FSW reporting good level of knowledge (p=0.0001) (Figure 1). In addition, more FSW in the intervention group (67%,27/40) strongly agreed to be interested in taking PrEP (p=0.01), while numbers remained similar in the control group (55%, 11/20, p=0.8). Three months after the intervention, 31.5% (12/38) of participants reported excellent PrEP knowledge, a significant improvement since the second survey (p=0.02).Figure 1. Self-reported Pre-Exposure Prophylaxis knowledge before and after intervention in the intervention and control groups. ConclusionThe use of a social media HIV prevention tool tailored to FSW in Cameroon improved PrEP awareness with good retention of knowledge. Cross contamination between groups might have hindered the differential impact of the brief intervention. Disclosures All Authors: No reported disclosures

Creativity, care and 'messy' drug use: A collective history of the early days of peer-led needle exchange in Dunedin, New Zealand.

Established in 1988, the New Zealand Needle Exchange Program (NZNEP) was the first needle exchange programme in the world to operate nation-wide under legal sanction. As in other countries, the ground for legislative reform was laid by activist action among the affected communities and their allies. In context of growing HIV/AIDS notifications, the provision of injecting equipment was positioned as a necessary, albeit politically contentious, public health priority. The NZNEP operated under a unique organisational model, with a national network of peer organisations formalised and supported to provide 'user pays' needle exchange. Unlike many other programmes of community empowerment instigated in response to HIV/AIDS, the NZNEP has over the past thirty years retained a significant degree of community control. Not without tensions, this history requires commemoration. The body of this essay was originally written as a chapter, focusing on the history of DIVO (Dunedin Intravenous Organisation), for a book to commemorate thirty years of the NZNEP. Under the auspices of a 'secret Facebook group' seven peers who worked at DIVO in the late 1980s and early 90s contributed the memories that make up this piece. As one of these peers, the author collated, coded and thematised these remembrances to create the story of DIVOS early days. From strategic positioning as a drug user organisation 'under wraps' DIVO garnered enough community support and institutional confidence to be 'out and proud' in advocating for the human rights of PWID. Ingenuity and action necessitated 'bending the rules' to protect against hepatitis C, and a community of care was recreated in the warmth of reconnection among the Facebook peer group. Tensions are inevitable in a peer-based organisation innovating in a context of precarious legitimacy, and they weave throughout this essay. This collective history is, however, primarily celebratory - of the achievements and legacy of a network of peers who were instrumental in providing care for their communities and advocating publicly for the rights of PWID in New Zealand.

Systemic Gendering in Facebook Group Participation

Communication is increasingly taking place in Facebook Groups around the world. Yet, we have little scientific knowledge of Facebook Groups at scale, especially the extent to which general systemic gendering is a pattern in participation in such groups. This knowledge deficit is problematic for digitalized and data-driven democratic societies. Therefore, this article aims to investigate gender differences in open, closed, and secret Facebook Groups. The study relies on a unique large-scale Facebook Group dataset from a sample that reflects the gender of Facebook users and the Facebook Groups they belong to in both Denmark and South Korea. By applying Bayesian models and developing a notion of participation that consists of both structural and actual participation, the study finds that the relation between country, gender, and participation is strongly modulated by gender differences. Females are more engaged than males in Denmark, while the opposite is true for South Korea. In both countries, privacy affects females’ participation more than males’. This article contributes to the field by presenting new large-scale findings that explore gender differences on three levels of Facebook Group privacy settings (open, closed, and secret) in a hitherto understudied communication space and, by doing so, it highlights the importance of privacy and country in predicting systemic gendering.

Digital Tools to Enhance Caregiver-Centered Communication

While it is recognized that caregiver engagement can improve processes and outcomes of care in gerontology, there are barriers to caregiver centered communication, including limited resources for health systems to devote services specifically to families, geographic distance and lack of time. Digital tools such as social media platforms and video-conferencing introduce opportunities for remote and often asynchronous communication. In this presentation, we discuss findings from two randomized clinical trials that explored digital tools to empower family caregivers. In the first we examined ways to use video-conferencing to enable family caregivers to become virtual team members during hospice interdisciplinary teams, and in the second trial we examine the use of secret Facebook groups to meet informational and emotional needs of family caregivers during episodes of care that are often linked to increased social isolation and loneliness. We discuss challenges and opportunities in designing digital tools to facilitate caregiver engagement and empowerment.

A novel research method for workshops and co-production of interventions: using a secret Facebook group

BackgroundCo-production of interventions is reliant on good communication and consensus between participants and researchers, but attending in-person meetings and workshops is hard for time-constrained groups such as new mums, who may be geographically dispersed without reliable transport. Discussions with a lay advisory group resulted in the decision to hold a workshop over a secret Facebook group. The aim of this study was to test the feasibility of a secret Facebook group for co-production activities. In the example presented, the population was women with previous gestational diabetes, the topic was physical inactivity, and the purpose was to develop an acceptable physical activity intervention.MethodsThe researchers created a secret Facebook group with content similar to an in-person workshop that sequentially progressed to develop a programme theory for an intervention. The researcher posted 1–2 times per day for 14 days, and members of the group were invited to comment and discuss the content. Feasibility and acceptability of the group were analysed using Facebook analytics and a post-workshop survey.ResultsTwenty-one participants took part. In total, 521 comments were provided in response to 18 posts of varying types (average = 28.9 comments per post). The total word count of participant comments was 21,142 words. The workshop was viewed positively, with 20 of 21 participants saying they liked the workshop “somewhat” or “a great deal”, and felt the group was a safe and open environment to share opinions. When asked if they would take part in something like this again, 15 of 21 said “Yes”. Participants mentioned the format was convenient; it allowed them to reflect on their experiences, and they liked helping research progress. Those who say “maybe” said it was difficult finding time and depended on what else was going on.ConclusionUsing a secret Facebook group as a method of co-production or as a workshop in the research process is a feasible and acceptable method. Social media holds significant potential for co-production and involvement in research for populations who are geographically dispersed or time-constrained, with an uncommon condition or other circumstances where in-person meetings are either not appropriate or not possible.

Mainstream Marginalization: Secret Political Organizing Through Social Media

Scholars have addressed how the socially marginalized, individuals with fringe viewpoints, or the politically marginalized in authoritarian regimes use social media to organize or connect in secret. Yet intensifying partisan polarization and prejudice in the United States has made it necessary to study how mainstream partisans in liberal democracies use social media to organize in secret. This study explores why mainstream partisans in the United States—average Republicans or Democrats—organize in secret online and analyzes the unique functions of social media for political organizing amid contextual marginalization. Through interviews with group leaders and a digital ethnography of a secret Facebook group in the United States, I find that mainstream partisans use social media to form secret political groups when they are the minority in their local community and that the online secret group serves several unique functions for members. First, the group operates as a community of solidarity for those reticent to disclose their political beliefs and as a community of contention to criticize and revitalize the minority Party in their region. The group also operates as a community of practice, allowing members to learn and rehearse communication among like-minded others. These findings hold implications for how scholars study communication in a digital and polarized era and how practitioners gauge public opinion.

Using a blended format (videoconference and face to face) to deliver a group psychosocial intervention to parents of autistic children

BackgroundParents and carers of autistic children report poor mental health. Autism stigma is a strong contributing factor to poor parental mental health, yet there are currently no interventions available that are evidenced to improve parents' mental health in part through increasing resilience to stigma. Childcare and travel are well known barriers to attendance and attrition rates for this population are high. MethodsA blended format psychosocial group support intervention was developed with the aim to improve parental mental health. Three sessions were delivered face to face, and five sessions via videoconference. A secret Facebook group was set up to support the intervention and increase retention rates. Mixed methods were used to assess the feasibility and acceptability of this mode of delivery for both the facilitator and service users. Attendance rates, fidelity and implementation issues are discussed. A qualitative focus group was conducted (n = 9) to explore the acceptability to the participants. Framework analysis was used to analyse the findings. ResultsAttendance rates were high with the online sessions having significantly higher attendance rates than the face to face sessions. The findings of the qualitative evaluation suggest that participants are positive about videoconferencing for a group support intervention. The facilitator reported sound quality, background distractions and late arrivals as challenges; the participants on the other hand, reported that the benefits far outweighed the negatives. Suggestions for improvement are made. ConclusionsThe results suggest that videoconference is a well-received method to provide a group support intervention to parents. Only preliminary conclusions can be drawn, owing to the small sample size.

Role Of Joint Loosening Yoga In Management Of Aromatase Inhibitor-Induced Arthralgia In Breast Cancer Survivors

PURPOSE:Aromatase inhibitor hormonal therapy causes joint pain in up to half of women, and up to 20% become non-compliant with the 5-10 year treatment schedule due to pain and discomfort. Non-compliance affects patient prognosis and survival. This pilot study investigated the efficacy of joint loosening yoga in improving aromatase inhibitor-induced joint pain and evaluated the feasibility of delivering the intervention on Facebook. METHODS:Breast cancer patients undergoing treatment with aromatase inhibitors with self-reported arthralgia were recruited via an IRB-approved announcement posted in two closed breast cancer support groups on Facebook to participate in a yoga study delivered on Facebook. Participants completed BPI, DASH, PRAI and WOMAC questionnaires online before and after the study. Intervention consisted of 12 joint loosening exercises performed in a chair, once daily for 12 minutes, Monday-Friday for 4 weeks. Asynchronous video demonstrations were available in a secret Facebook group and viewing confirmed by typing "done" (time-stamped) in comments. RESULTS:200 women responded. 38 met the inclusion criteria/consent, 26 completed the online consent, interventions and pre/post questionnaires. Participants were based in US, Canada and UK. Paired simple t tests results showed significant (P < 0.05) improvement in all the pain measures and quality of life parameters after yoga intervention compared to baseline. CONCLUSIONS: This study provides the first evidence that it is feasible to teach joint loosening yoga to patients on Facebook and that the intervention significantly improves aromatase inhibitor-induced arthralgia. Teaching yoga via social media may provide better access to this therapeutic modality to patients at all points in the cancer care continuum globally.

Virtually Trans: an Australian Facebook group supporting gender diverse adults' health and wellbeing.

Social networking sites are the primary means by which trans and gender diverse people meet, enabling both community contact and information exchange. This study considers the meaning of participation in a secret Facebook group for trans and gender diverse adults in Melbourne (Australia). A peer ethnographic methodology was used to study the Melbourne-based group listed under the pseudonym 'Virtually Trans'. Qualitative semi-structured interviews were conducted with 12 Virtually Trans group members. Interviews were transcribed and thematically analysed. Interview data were supplemented with field notes written throughout online participation over an 8-month period to add richness and provide context to the data. Three major themes were developed from this analysis. First, experiences outside of Virtually Trans, most notably within health care settings, were perceived to be unsafe. Second, practices of care in Virtually Trans conferred a sense of kinship and identity affirmation. Finally, Virtually Trans enabled localized information exchange between peers. Virtually Trans is not a neutral platform of self-performance but a safe(r) environment for expanding the gendered possibilities of who and how people may become. This study highlights the importance of a secret Facebook group in filling care, information and resource gaps experienced by trans and gender diverse people within a major metropolitan setting. The findings have implications for practitioners working with trans and gender diverse adults and peer health navigation.

Midwife-moderated social media groups as a validated information source for women during pregnancy

BackgroundWidespread use of the internet has fundamentally altered the way people access health information and communicate with health providers. Pregnant women are a group who are particularly highly motivated to seek out information online. However, where mothers actually obtain their information, who they trust to supply it, and whether or not it actually fulfils their needs is often unclear. This paper examines the experiences of women accessing advice and information on pregnancy and childbirth through a dedicated social-media platform, mediated by qualified midwives. The study formed part of a larger research project that focussed on professionally moderated online learning in maternity care, and the role of online communities. This paper reports on aspects of midwife mediated information provision in the context of these online communities. MethodsTwo secret (i.e. private / invitation only) Facebook groups were created. Both groups were moderated by 2 qualified midwives. One group had 17 mothers and the other 14 mothers. Both groups ran for 35 weeks. Data and analysisThe data included the written and spoken words of group participants and midwife-moderators in i) face-to-face (n = 4) and online (n = 4) post-intervention focus groups; ii) one-to-one interviews with group participants and midwife moderators (n = 24); iii) the complete corpus of text-based interaction across both groups; iv) a sub-set of private message sessions (n = 24) between individual participants and midwife-moderators. Thematic analysis was applied to the combined dataset. FindingsParticipants found engagement with midwives and other pregnant women via a social media group convenient and accessible. The groups provided a safe space for the sharing and validation of maternity relevant information. Members trusted their midwife-moderators to ensure information was reliable. For many members, the group became the primary source of pregnancy related information. ConclusionMidwife-mediated social media groups offer a highly effective way of providing individualised information provision and social support for pregnant woman. Access to a group can also significantly impact on perceptions of relational continuity.

Social Media Interventions for Risky Drinking Among Adolescents and Emerging Adults: Protocol for a Randomized Controlled Trial.

BackgroundDespite intervention efforts to date, the prevalence of risky drinking among adolescents and emerging adults remains high, increasing the risk for health consequences and the development of alcohol use disorders. Peer influences are particularly salient among this age group, including via social media. Thus, the development of efficacious early interventions for youth, delivered with a broad reach via trained peers on social media, could have an important role in addressing risky drinking and concomitant drug use.ObjectiveThis paper describes the protocol of a randomized controlled trial (RCT) testing the efficacy of a social media intervention among adolescents and emerging adults who meet the criteria for risky drinking (using the Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]), delivered with and without financial incentives for participation, compared with an attention placebo control condition (ie, entertaining social media content), on alcohol consumption and consequences.MethodsThis RCT involved recruiting 955 youths (aged 16-24 years) via advertisements on Facebook and Instagram to self-administer a brief web-based screening survey. Those screening positive for past 3-month risky drinking (AUDIT-C positive: ages 16-17 years: ≥3 females and ≥4 males; and ages 18-24 years: ≥4 females and ≥5 males) were eligible for the RCT. After providing consent (a waiver of parental consent was obtained for minors), participants completed a web-based baseline survey and several verification procedures, including a selfie photo matched to Facebook profile photos. Participants were then randomized to join invitation-only secret Facebook groups, which were not searchable or viewable by parents, friends, or anyone not recruited by the study. The 3 conditions were social media intervention with incentives, social media intervention without incentives (SMI), and attention placebo control. Each condition lasted 8 weeks and consisted of bachelor’s-level and master’s-level therapist electronic coaches posting relevant content and responding to participants’ posts in a manner consistent with Motivational Interviewing. Participants in the control condition and SMI condition did not receive payments but were blind to condition assignment between these 2 conditions. Follow-ups are ongoing and occur at 3, 6, and 12 months poststart of the groups.ResultsWe enrolled 955 participants over 10 waves of recruitment who screened positive for risky drinking into the RCT.ConclusionsThe findings of this study will provide the critical next step in delivering early alcohol interventions to the youth, capitalizing on social media platforms, which could have significant public health impact by altering alcohol use trajectories of adolescents and emerging adults engaged in risky drinking.Trial RegistrationClinicalTrials.gov NCT02809586; https://clinicaltrials.gov/ct2/show/NCT02809586.International Registered Report Identifier (IRRID)DERR1-10.2196/16688

Corrigendum to: Connectedness Based on Shared Engagement Predicts Remote Biochemically Verified Quit Status Within Smoking Cessation Treatment Groups on Facebook.

INTRODUCTION Engagement with online content and online social network integration are associated with smoking behavior change, but less is known about social dynamics of shared engagement between participants in group-based social media interventions. METHODS Participants were 251 young adult smokers aged 18 to 25 assigned to one of 29 secret Facebook groups tailored to their readiness to quit smoking (pre-contemplation, contemplation, and preparation). Groups varied in size and were randomly assigned to receive monetary incentives for engagement. All groups received daily posts for 90 days and were assessed for remote biochemically verified smoking abstinence at the end of the intervention. Across 29 groups, we examined associations between group features (group size, incentive condition, readiness to quit) with how connected members were within the group based on shared engagement with the same content (measured by density). At the individual level, we examined associations between 7-day biochemically verified smoking abstinence and how connected an individual was within the group (measured by degree centrality). RESULTS After adjusting for comment volume, being in a contemplation group (vs. pre-contemplation group) was associated with a decrease in comment-based density. Individual degree centrality was significantly associated with biochemically verified smoking abstinence for both comments and likes. CONCLUSIONS Future group-based social media interventions for smoking cessation may want to focus on promoting connected engagement between participants, rather than simply quantity of engagement. IMPLICATIONS Participants in a smoking cessation intervention delivered through Facebook groups were more likely to have biochemically verified smoking abstinence if they were more connected to the rest of the group via shared engagement. Promoting shared engagement between participants may be more likely to promote behavior change than volume of engagement alone.

Use of Social Media to Teach Global Reconstructive Surgery: Initiation of a Secret Facebook Group.

Background:The ReSurge Global Training Program (RGTP) is a model for building reconstructive surgery capacity in low- and middle-income countries.1 The aim of this study is to assess attitudes toward social media, to develop an initial RGTP Facebook Education Group, and to assess the early results of the group’s implementation.Methods:A survey of the RGTP community assessed group demographic, interests, concerns, and familiarity with Facebook from July to August of 2018. A “secret” Facebook group was launched on October 30, 2018. Narrated lectures were posted weekly to the group. Educational cases were shared on the group’s discussion page. Facebook “Group Insights” and individual post review were used to obtain group statistics.Results:Senior faculty were less likely to have an existing Facebook account (58% vs 93%, P < 0.05). Trainees were more confident using Facebook (97% vs 54%, P < 0.05) and favored viewing the training curriculum through Facebook (93.0%, P < 0.05). At 6 months, the group enrolled 103 members from 14 countries. Twenty-two lectures were posted, obtaining an average of 59.4 views (range, 36–78). Fourteen cases were presented for group discussion with an average of 61.1 views (range, 43–87).Conclusions:The RGTP Facebook group has continued to expand in its early months. This group allows our community to view RGTP’s training curriculum, while providing global access to expert opinion and collaboration. The secret Facebook group can be used as an effective and easy-to-use platform for educational outreach in global reconstructive surgery.

Subjective Experiences of a Cisgender/Transgender Dichotomy: Implications for Occupation-Focused Research.

The subjectivity of researchers has received little attention in occupational research of trans and/or gender diverse (TGD) lives. Secondary thematic analysis of a peer ethnography was conducted to explore the meaning and epistemological significance of a cisgender/transgender dichotomy for TGD adults. The primary research comprised an occupational analysis of participation in a secret Facebook group ("Virtually Trans") for TGD adults who were assigned female at birth and live in Melbourne, Australia. Three themes were developed from this secondary analysis of the experiences of 12 group members. First, an oppositional cisgender/transgender dichotomy was salient and significant to all participants. Second, belonging norms, while profoundly felt, also obscured intragroup differences and opportunity for outgroup contact. Finally, participants recognized the need for self-reflexive allies to document the varied occupational experiences and priorities of this cohort. A cisgender/transgender dichotomy is a significant ontological distinction that must be attended to in TGD occupation-focused research.