Social Media-based Intervention Research Articles

Associations Between Characteristics of Adolescent and Young Adult Cancer Survivors and Their Use of Different Social Media Platforms: An Observational Study of Social Media Accounts.

Background: The growing number of adolescent and young adult (AYA) cancer survivors and their unmet needs demand innovative communication and care strategies. This study uses social media data to examine how survivors' demographic and clinical characteristics relate to their social media use. Methods: Data from 300 AYA cancer survivors on six social media sites (YouTube, Instagram, Facebook, TikTok, Reddit, X/formerly Twitter) were collected between August 2022 and March 2023 and analyzed using descriptive statistics and statistical tests (chi-square, Fisher's exact, Welch, Games-Howell post-hoc, logistic regression). Results: Significant differences were observed across platforms for mean current age (p < 0.001) and age at diagnosis (p < 0.001). We also found significant associations between social media type used and current age, age at diagnosis, years since diagnosis, and the timing of social media account creation. AYAs who created their social media account post-diagnosis were less likely to use YouTube (p = 0.003) and more likely to use Facebook (p = 0.009). Treatment completion was associated with increased use of platform X (p = 0.004). Non-White individuals in our sample were less likely to use Facebook (p = 0.008). Significant associations were found between observed sex and platform usage (p < 0.001), with males more likely to use Reddit (p < 0.001) and X (p < 0.001). Conclusions: Significant associations were found between demographic and clinical attributes of AYA cancer survivors and the type of social media they used, suggesting that AYA-specific social media-based interventions should be tailored to subgroup characteristics (e.g., social media type, developmental stage based on age at diagnosis and current age, sex).

Effect of Supportive Care on Quality of Life for People Living with Human Immunodeficiency Virus: A Systematic Review

The survival of people living with HIV (PLWH) affects physical, psychological, sexual, social, and financial circumstances during the care and treatment phase. Supportive care is an effective intervention associated with a better quality of life. The aim of this systematic study was to identify effect supportive care intervention on quality-of-life infected people. This study was a systematic review to examine the effect of supportive care in PLWH. Four databases including Science Direct, ProQuest, PubMed, and Wiley library were included to identify the relevant articles. A total of eight articles out of the 247 publications potentially met the inclusion criteria. Supportive care was grouped into four categories, including Community Based Intervention, M-Health Intervention, Social Media-Based Interventions as well as Psychosocial Interventions. The combination of all interventions showed that supportive care needs to be prescribed in line with the conditions and needs of PLWH. Conclusion, several supportive care approaches including Group Support Psychotherapy (GSP), Peer Support (PS), Run4Love WeChat, ALWH treatment strategy, effective communication, and psychosocial assessment, Mental health care pathway PASEO and combination logotherapy, ACT, as well as family psychoeducation (FPE) affected the quality of life for PLWH. This helped in characterizing the intervention and its effect on the conditions of HIV patients.Keywords: Databases; Supportive care; Psychosocial interventions; Quality of life

Intent mining framework for understanding online conversations on vaping to inform social media-based intervention design

ABSTRACT The recent surge in the usage of e-cigarettes amongst youth has highlighted a long-standing societal crisis. To assist public health agencies in policymaking, past research often employed traditional survey-based methods to understand youth behavior, which suffer from response biases and scalability, are time-consuming, and their findings often lag the fast-changing public behavior. Our study fills this gap by using social media as a complementary data source to understand user intentions for vape usage at a large scale, thus, providing an alternative to traditional survey-based methods. In this paper, we propose a novel user intent mining framework under the guidance of social cognitive theory for health behavioral interventions that helps study user intentions across different social media platforms. We then employ this framework to investigate the feasibility of automated intent mining on social media by formulating a multi-class classification task, employing machine learning algorithms to classify a social media message across relevant intent classes: Accusational, Anecdotal, Informational, Justificational and Promotional. The analyses indicate that Accusational tweets and Anecdotal messages were most prevalent on X/Twitter and Reddit respectively. We further provide novel insights on the conversational context using topic modeling analysis and psychometric analysis consequently, informing intervention designs and assisting health analysts.

Feasibility and Preliminary Effects of a Social Media-Based Peer-Group Mobile Messaging Smoking Cessation Intervention Among Chinese Immigrants who Smoke: Pilot Randomized Controlled Trial.

Chinese immigrants experience significant disparities in tobacco use. Culturally adapted tobacco treatments targeting this population are sparse and the use is low. The low use of these treatment programs is attributed to their exclusive focus on individuals who are ready to quit and the wide range of barriers that Chinese immigrants face to access these programs. To support Chinese immigrant smokers at all levels of readiness to quit and address their access barriers, we developed the WeChat Quit Coach, a culturally and linguistically appropriate WeChat (Tencent Holdings Limited)-based peer group mobile messaging smoking cessation intervention. This study aims to assess the feasibility, acceptability, and preliminary effects of WeChat Quit Coach. We enrolled a total of 60 Chinese immigrant smokers in 2022 in New York City for a pilot randomized controlled trial (RCT) and a single-arm pilot test. The first 40 participants were randomized to either the intervention arm (WeChat Quit Coach) or the control arm (self-help print material) using 1:1 block randomization stratified by sex. WeChat Quit Coach lasted 6 weeks, featuring small peer groups moderated by a coach, daily text messages with text questions, and chat-based instant messaging support from the coach in response to peer questions. The next 20 participants were enrolled in the single-arm pilot test to further assess intervention feasibility and acceptability. All 60 participants were offered a 4-week supply of complimentary nicotine replacement therapy. Surveys were administered at baseline and 6 weeks, with participants in the pilot RCT completing an additional survey at 6 months and biochemical verification of abstinence at both follow-ups. Of 74 individuals screened, 68 (92%) were eligible and 60 (88%) were enrolled. The majority of participants, with a mean age of 42.5 (SD 13.8) years, were male (49/60, 82%) and not ready to quit, with 70% (42/60) in the precontemplation or contemplation stage at the time of enrollment. The pilot RCT had follow-up rates of 98% (39/40) at 6 weeks and 93% (37/40) at 6 months, while the single-arm test achieved 100% follow-up at 6 weeks. On average, participants responded to daily text questions for 25.1 days over the 42-day intervention period and 23% (9/40) used the chat-based instant messaging support. Most participants were satisfied with WeChat Quit Coach (36/39, 92%) and would recommend it to others (32/39, 82%). At 6 months, self-reported 7-day point prevalence abstinence rates were 25% (5/20) in the intervention arm and 15% (3/20) in the control arm, with biochemically verified abstinence rates of 25% (5/20) and 5% (1/20), respectively. WeChat Quit Coach was feasible and well-received by Chinese immigrants who smoke and produced promising effects on abstinence. Large trials are warranted to assess its efficacy in promoting abstinence in this underserved population. ClinicalTrials.gov NCT05130788; https://clinicaltrials.gov/study/NCT05130788.

Social Media-Based Brief Video Interventions to Support Youths' Mental Health.

Social media platforms are communication forums with potential benefits and disadvantages for youths' mental health. In this column, the author focuses on two main themes. First, recognizing the need for carefully crafted interventions, the author advocates for the use of crowdsourcing platforms to test and refine social media-based video content. These platforms enable the development of engaging, safe, and stigma-reducing videos tailored to meet the needs of diverse youths. Second, the author proposes the establishment of strategic frameworks designed to empower youths to produce and share these videos effectively, enhancing the positive effect of social media on mental health discourse.

Effectiveness of Social Media-Based Intervention in Intention Change of Adolescents for Promoting Sexual Health Behavior in Western Terai of Nepal.

Sexually transmitted infections (STIs) in adolescents are among the major public health challenges that have to be prevented in time. Traditional education falls short of reach; social media offers accessible ways. However, there is no research on such an issue in Nepal. Accordingly, this study was conducted to assess the effectiveness of a social media-based health education intervention in changing the intention of promoting sexual health among adolescents in Nepal. Study Design: A quasi-experimental study. A total of 160 adolescent students aged 14-19 years old from four purposively selected schools were evenly divided into intervention and non-intervention groups. Sampling and data collection were performed between May and June 2023. Data were collected through self-administered questionnaires for pretest and posttest evaluation. The intervention was delivered and followed up through a Facebook Messenger group. The obtained data were managed and analyzed using SPSS 21, with a significance level of 5%. Social media-based health education interventions played a significant role in promoting the sexual health behavior of adolescents. The adolescents' knowledge and attitude scores on STIs increased from 2.33 to 4.62 and from 21.87 to 26.30. In addition, their scores on subjective norms, perceived behavioral control, and intentions in promoting sexual behavior increased from 13.93 to 17.59, from 19.96 to 25.40, and from 13.07 to 18.06, respectively, which were statistically significant. The utilization of social media platforms such as Facebook Messenger groups is an effective medium for delivering health educational messages. Hence, increasing social media-based health education is a cost-effective intervention for promoting the health and sexual behaviors of adolescents.

Utilization of Social Media for the Prevention and Control of HIV/AIDS: A Scoping Review.

Social media has been used widely in public health for understanding health risks and intervening to improve health. However, the utilization of social media for HIV prevention and control interventions has not been clearly characterized. We conducted a scoping review on the utilization of social media for HIV prevention and control to identify gaps in the literature and highlight opportunities for future research and intervention. A comprehensive search of seven databases was performed: PubMed, Embase, CINAHL Complete (EBSCO), PsycInfo (EBSCO), Scopus, and WOS (Science Citation Index Expanded (SCI-EXPANDED). The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used as a framework. A total of 790 articles were screened at the title and abstract level, and 78 were screened at the full-text level. Twenty-three articles met the eligibility criteria for review. We found that Facebook was still the most common social media service used to reach target populations. Lesbian, gay, bisexual and transgender (LGBT) individuals were the primary groups and were the most common targets of social media-based HIV prevention interventions. Outcomes of social media-based interventions, such as increased HIV testing, social networking and social support, condom use attitudes, behavioral skills, and research participation, were reported. Most social media-based interventions have emphasized HIV prevention, with fewer interventions focused on improving linkage to care and adherence to treatment among people living with HIV. Future studies may benefit from using social media for interventions to improve HIV-related outcomes in high-risk populations. This review highlights the potential and challenges of social media approaches for HIV/AIDS prevention and control.

Development of a community intervention combining social media-based health education plus exercise programme (SHEEP) to improve muscle function among young-old adults with possible sarcopenia: Co-design approach

ObjectivesThere is no precedent for the use of social media in preventing sarcopenia. The aim of this study is to develop a social media-based intervention programme for the young-old population in the community in China to improve their awareness and behaviours regarding sarcopenia prevention. Study designUsing guidelines for developing complex interventions, this study was divided into two main phases: a co-development phase and a preliminary test phase. Both were carried out in Changsha, China. The development phase employed co-design methodology with relevant stakeholders, including two rounds of consultation with patient and public involvement (12 members) and two rounds of focus groups (30 participants); this was followed by the three-week preliminary test phase (22 participants). Main outcome measuresThis study evaluated the consultation with patient and public involvement, and mainly collected qualitative data from the two rounds of focus group interviews and a final semi-structured interview following the preliminary test, so as to explore the participants' experiences, comments, and suggestions for revising the social media-based intervention. Handgrip strength was also evaluated. ResultsThe health education included seven videos of 4–6 min each related to sarcopenia, including information on the concept, influencing factors, adverse effects, manifestations, screening methods, and preventions. The exercise video consisted of four types of training (warm-up, aerobic, resistance, and flexibility training) and lasted 30 min, with a suggested engagement of at least 3 days/week. The specific contents and “dosage” of the final intervention were unanimously favourable to the diverse stakeholders involved (older adults with possible sarcopenia, experts, researchers). After the preliminary test, an improvement in handgrip strength was observed, from M15.92±SD5.22 kg to M19.13±SD5.44 kg (T = −5.44, P < 0.001). Subgroup analysis revealed that this improvement was evident in both men and women. ConclusionsThe social media-based intervention was universally endorsed by the participants and showed indications of a positive influence on sarcopenia. A feasibility study is now needed.

Comparative analysis of social media-based interventions for adolescent reproductive health education.

Comparative analysis of social media-based interventions for adolescent reproductive health education.

The Effects of Peer Mental Illness Narratives on Reducing Stigma Among U.S. Marginalized College Students

ABSTRACT Mental health stigma remains a significant barrier to accessing mental health care and treatment, particularly among racial, ethnic, gender, and LGBTQIA+ underrepresented groups in the United States. This study aimed to investigate the relative persuasiveness of mental health narratives featuring both marginalized and non-marginalized characters in reducing stigma among college students. We conducted an online between-subjects experiment with a sample size of 292 participants to explore the impacts of message format (narrative vs. non-narrative), narrative point of view (first-person vs. third-person), and character similarity (marginalized vs. non-marginalized voices) on the persuasion process, specifically targeting the reduction of stigma and changes in attitudes toward those seeking mental health services. Findings revealed that the use of narrative messaging had no effect on reducing mental health stigma or treatment attitudes, but narrative campaigns featuring members of underrepresented groups did enhance one’s perceived similarity with mediated characters, which in turn resulted in more support for seeking mental health treatment. These findings have implications for the design of social media-based anti-stigma interventions and narrative persuasion in mental health research.

The “memeification” of sexual health communication on Instagram

ABSTRACT The lack of accurate and comprehensive sexual health education in the USA persists as a pressing public health issue. The Sex Wrap (TSW) is a multimedia sexual health podcast and social media presence that educates followers on sexual health and ancillary themes such as sexuality, relationships and communication. TSW’s Instagram account repackages the evidence-based sexual health information discussed during the podcast into Internet memes. We analysed the top-performing TSW posts from Jan 2019-Dec 2020 according to Instagram’s engagement metrics to determine what type of posts were most interesting to followers and begin to understand how social media helps drive interventions. The meme-based sexual health intervention via TSW’s Instagram increased engagement, improved reach, and converted followers to podcast listeners. Insight data demonstrates how social media can address the sexual health education disparities caused by the failure of abstinence-only-until-marriage (AOUM) curricula. This case study exhibits how social media-based interventions can comprehensively fill existing gaps in sexual health education.

Social media use and health promotion among cancer survivors.

Social media is becoming recognized as an effective platform for cancer health promotion, education, care, and support. However, its utility as a health promotion tool remains relatively unexplored. Using cross-sectional data from the 2017-2020 Health Information National Trends Survey, we evaluated health-related usage of social media among cancer survivors and individuals without a history of cancer. We also examined the participant characteristics associated with social media usage and evaluated therelationship between social media use and positive health behaviors among the cancer survivors. Overall, cancer survivors (n=2579) were as likely as individuals without a history of cancer to use social media for health promotion. Males [OR 0.65; 95% CI (0.45, 0.93)] and older adults (>60years old) [OR 0.27; 95% CI(0.10, 0.77)] were less likely to use social media, while higher income [OR 2.27; 95% CI (1.05, 4.92) middle income; OR 1.90; 95% CI (1.17, 3.09) high income] and educational levels [OR 3.29; 95% CI (1.85, 5.84) some college; OR 2.36; 95% CI (1.30, 4.28) college graduate or more] were associated with more health-related social media use among survivors. Cancer survivors used social media for online support groups more than other individuals, and those who used at least one form of social media for health-related purposes increasingly meet national recommendations for strength training compared to non-users [OR 2.15; 95% CI (1.48, 3.13)]. Our findings demonstrate the potential utility of social media to promote positive health behaviors among cancer survivors. Further research is needed to describe the efficacy of social media-based interventions for improving health behaviors in diverse cancer populations.

Impact of participation as a peer change agent on peer change agents themselves: a quantitative study of a peer-led, social media-based PrEP promotion intervention.

Despite the adoption of pre-exposure prophylaxis (PrEP) as a crucial HIV intervention, uptake remains suboptimal among men who have sex with men, a sexual minority group, due to barriers like cost and stigma. Peer change agents (PCAs) disseminate PrEP information within their social networks. This study explores the reciprocal effects of an online community-based participatory intervention on PCAs, focusing on their transformed PrEP uptake perceptions-leadership efficacy, social network dynamics, attitudes, perceived benefits and barriers and self-efficacy. Leveraging insights from the PrEP Chicago Study, our research addresses a key gap in community-based participatory interventions for PrEP uptake: the transformative experiences and perception shifts of PCAs involved in these interventions. We engaged 20 men who have sex with men, aged 18-45, as PCAs in a one-group pretest-posttest design intervention, which disseminated PrEP communications within their preferred online networks. We utilized the PrEP Chicago Study's 45 Likert items, tailored to reveal the PCAs' transformative potential. Data on PrEP uptake perceptions, sociodemographics and social media use were captured and analyzed using the Wilcoxon matched-pairs signed-rank test, a nonparametric method. PCAs demonstrated significant changes in their PrEP uptake perceptions, including leadership capacity, social network dynamics, attitudes toward PrEP, perceived benefits, barriers and self-efficacy. Our intervention highlights the reciprocal transformation PCAs undergo when disseminating PrEP information. This study adds a new dimension to community-based PrEP interventions and underscores the need for continued refinement of peer-led strategies to optimize the transformative potential of PCAs.

Social media kindness intervention increases innovation in college students

This study investigated the impact of a kindness intervention on Instagram on innovation and empathy among 50 participants. Divided into a kindness group (N = 25), instructed to post kind comments, and a control group (N = 25) with no such instructions, participants posted comments for three weeks. The intervention's effect on innovation, defined as abstract thinking and idea generation, and empathy were assessed at baseline and after the intervention. Results revealed a significant interaction effect between the intervention and innovation, with a trend towards increased innovation in the kindness group. No significant changes in empathy were observed. These findings suggest a complex relationship between social media-based kindness interventions and cognitive skills like innovation, highlighting the need for further research in this domain. This finding is the first step in investigating how to leverage social media to positively affect prosocial behavior and cognitive skills.

Perceptions and Experiences of Undergraduate Students Regarding Social Media as a Tool for Government COVID-19-Related Messages: A Qualitative Study in Nottingham, UK.

The rise of social media has given way to its use as a form of public health communication. Previous research has shown social media-based interventions to be effective, particularly for university students. Social media was used as a tool for public health messaging during the COVID-19 pandemic; however, there is a lack of information regarding the experiences and perceptions of such messaging and its effectiveness among UK university students. A qualitative study was conducted to explore the perceptions and experiences of public health messaging on social media during the pandemic, as well as the effects of such messaging. Fourteen semi-structured interviews with undergraduate students at the University of Nottingham, UK, were conducted. Five main themes were identified: effects of COVID-19 on university students, use of social media by university students, COVID-19 messaging on social media, effects of public health messaging on social media in compliance with COVID-19 guidelines, and improving public health messaging for the future. This study provides a novel insight into the experiences and perceptions of undergraduate students at a UK university regarding public health messaging on social media during the COVID-19 pandemic.

Social media intervention for promoting breastfeeding among WIC participants.

Social media have emerged as a promising communication channel for promoting breastfeeding among a new generation of mothers. Yet, there is no published study reporting the effects of a large-scale social media intervention on key breastfeeding-related perceptions, attitudes, and behaviors. As a component of its breastfeeding promotion campaign, the Women, Infants, and Children (WIC) program implemented a 12-month intervention using Facebook and Instagram and subsequently evaluated the outcomes by surveying WIC-participating women (N = 832) twice, immediately before and after the intervention. Based on their level of exposure to the intervention messages, the women were retrospectively classified into two groups, resulting in a two-group (no-low exposure vs. medium-high exposure) quasi-experiment. Women in the medium-high exposure group, in comparison with women in the no-low exposure group, exhibited higher campaign awareness (p < .001), visits to the campaign website (p < .001), and engagement with the website content (p < .001). They also reported more positive breastfeeding attitudes (M = 17.26 vs. M = 16.51, p < .05), self-efficacy (M = 54.48 vs. M = 49.94, p < .01), and social support (M = 27.37 vs. M = 25.11, p < .001). But they did not differ from women in the no-low exposure group in breastfeeding initiation (p > .05) and duration (p > .05). In conclusion, a social media-based intervention resulted in more positive breastfeeding attitudes, higher self-efficacy, and higher perceived social support. Future studies need to investigate the optimal level of intervention message dosage that prompts significant behavioral changes.

WeChat-Based Intervention for Chinese Immigrants With Hypertension: Development and Evaluation Study.

Despite Chinese immigrants having a higher or comparable proportion of hypertension (HTN) compared to non-Hispanic White and Hispanic individuals, there are no effective technology-based intervention studies that target HTN management in Chinese immigrants in the United States. The aim of this study was to develop and pilot-test the efficacy of a culturally and linguistically sensitive social media-based intervention (WeChat) for Chinese immigrants to improve blood pressure (BP) control, antihypertensive medication adherence, and self-efficacy. The study was conducted in 2020 with a pre- and posttest design (N=20). A WeChat-based intervention was implemented using one 20-minute video presentation plus one 20-minute nurse counseling session via WeChat at the baseline, followed by 4 biweekly 20-minute nurse counseling sessions via WeChat calls. The primary outcome (BP control) and secondary outcomes, including medication adherence and self-efficacy in HTN management, were measured at baseline and at 6 months. The participants' mean age was 68.9 (SD 10.2; range: 51-86) years. The majority of the participants were female (n=13, 65%), had a high school degree or less (n=15, 75%), were married (n=16, 80%), not religious (n=13, 65%), and not employed (n=12, 60%). The results showed that the mean baseline systolic BP was 131.43 (SD 9.61) mmHg, and the mean diastolic BP was 79.79 (SD 9.62) mmHg. The 6-month outcome showed a reduction of systolic BP (-0.74, SD 9.18 mmHg; P=.05) and diastolic BP (-0.96, SD 6.92 mmHg; P=.001). The mean score for medication adherence at baseline was 4.50 (SD 1.70), and it significantly improved to 3.65 (SD 1.18) at 6 months (reversely scored; possible range was 1-5, with 1 being the best score; P=.001). Self-efficacy in HTN management had a trend in reduction from a baseline score of 8.28 (SD 1.25) decreasing to 7.93 (SD 1.48) at 6 months, with a mean difference of 0.34 (SD 2.02), with a score of 0 indicating the lowest self-efficacy and a score of 10 indicating the highest self-efficacy. Our WeChat-based HTN management program showed a significant improvement in diastolic BP and medication adherence as well as a trend of reduction for systolic BP and self-efficacy in managing HTN in Chinese immigrants. Compared to the traditional health care system, the proposed WeChat-based HTN management program has a low cost and is easy to implement. Thus, further investigation is recommended to generate further results. This intervention should be tested across different regions and clinical settings to verify the findings. The long-term goal is to implement the intervention in clinical settings to help Chinese immigrants at large achieve better HTN management.

"Effect of Social Media-Based Educational Intervention on Mental Health Literacy Among Male High School Students in Ramhormoz City: A Randomized Controlled Trial Study Protocol" (Preprint)

"Effect of Social Media-Based Educational Intervention on Mental Health Literacy Among Male High School Students in Ramhormoz City: A Randomized Controlled Trial Study Protocol" (Preprint)

Unleashing the Potential of Social Media: Enhancing Intercultural Communication Skills in the Hospitality and Tourism Context

Intercultural communication skills play a vital role in achieving success in the global hospitality and tourism profession. This study examined the effectiveness of leveraging social media, specifically YouTube (San Bruno, CA, USA), in developing intercultural competence (ICC) among students enrolled in service management courses within the hospitality and tourism department. The research involved 112 Korean students who were divided into two groups: the experimental group (n = 57), which participated in social media-integrated intercultural learning activities; and the control group (n = 55), which engaged in traditional intercultural learning activities. Data were collected through pre- and post-questionnaires using the Intercultural Competence Scale (ICS). The findings indicated that social media-based intercultural activities on YouTube were more effective in improving learners’ ICC levels compared to traditional classroom activities. Significant differences in mean gain scores underscored the impact of social media-based interventions in promoting intercultural learning and fostering meaningful intercultural engagement. The analysis also revealed noteworthy distinctions between the experimental and control groups across various dimensions of ICC. This study emphasized the value of social media platforms, including YouTube, in facilitating positive changes in affective orientation, self-efficacy, behavior performance, and intercultural consciousness. The research provided practical insights for educators and institutions in the hospitality industry to integrate social media-based intercultural activities, thereby enhancing students’ intercultural learning experiences and nurturing their ICC.

Analyzing Twitter-Based Social Networks of Support Communities for Hispanic and African American Family Caregivers of Persons with Dementia.

We applied social network analysis to compare Hispanic and Black dementia caregiving networks on Twitter that were established as part of a clinical trial from January 12, 2022, to October 31, 2022. We extracted Twitter data from our caregiver support communities (N=1980 followers, 811 enrollees) via the Twitter API and used social network analysis software to compare friend/follower interactions within each Hispanic and Black caregiving network. Analysis of the social networks revealed that enrolled family caregivers without prior social media competency had overall low connectedness compared to both enrolled and non-enrolled caregivers with social media competency, who were more integrated into the communities that developed through the clinical trial, partly due to their ties to external dementia caregiving groups. These observed dynamics will help to guide further social media-based interventions and also support the observation that our recruitment strategies effectively enrolled family caregivers with various levels of social media competency.