Social media is becoming an integral part of daily life and provides easy access to connect with others. In addition to facilitating social companionship, social media can also provide informational and instrumental support, especially during critical times when individuals have significant unmet needs. Patients with cancer are increasingly turning to social media platforms to help address their social, emotional, and physical health needs. But the effectiveness of these social media-based interventions is not known nor are the specific mechanisms of these interventions clear.
A new study published in the Journal of Cancer Survivorship performed an analysis of previously published trials reporting the efficacy of social media-based interventions at improving patient outcomes. Li En Dana Siew, PhD from the Nursing Department at Singapore General Hospital led this systematic review and meta-analysis which demonstrated that social media-based interventions can improve cancer patients’ quality of life while also reducing their anxiety.
The research team used a rigorous, systematic approach to identifying and reviewing randomized clinical trials that examined the effect of social media interventions on cancer patient outcomes. They found 43 articles published between 2001 and 2021 which included 6,239 patients with cancer across 11 countries. Of these 43 articles, 29 included data that were included in the meta-analysis of patient outcomes.
The media types within these trials varied: 40% used websites, 26% used social media, 21% used mobile phone applications, and 12% used internet-based media. All involved two-way communication either synchronously or asynchronously and had online social networks, peer grouping, and communication. The interventions varied in frequency (e.g., several times a day to a few times a week) and duration (e.g., a day to a few years). The comparator interventions consisted of usual care, waitlist controls, and active comparators.
Quality of life significantly improved in the 17 studies that assessed this outcome and had accessible data. These improvements lasted over time with significant improvements remaining after three months. Findings were particularly strong in interventions that used mobile phones and with more social media features.
Anxiety symptoms also significantly improved in the 10 studies that had data to be analyzed. These results appeared only in the post-intervention assessment and not the one month follow-up. Specifically, interventions that had flexible frequency had stronger effects in reducing anxiety.
Depression symptoms did not significantly improve across the 17 studies with available data. No specific features or patient characteristics impacted depression symptoms.
The researchers conclude that this meta-analysis demonstrates that social media-based interventions are effective (with small to medium effect sizes) at improving patients’ quality of life and anxiety. Notably, these findings are maintained over time and not limited to the intervention period alone, a common finding among technology-based interventions. Rather, the researchers suggest that these interventions spur the development of social connection through features like peer grouping, group communication, and online social networks. By connecting with people like them, they receive validation about their experiences and have the opportunity to exchange experiences and information.
The specific features of social media that appear to most drive these outcomes include having a variety of features and using identity representation. The variety of features (e.g., messaging, blog posting, photo sharing, etc.) allow people to use the social media intervention based on their preference, resulting in a more inclusive intervention with increased usage. The identity representation allows patients to create profiles or avatars that personalize their presence in the intervention. This allows them to identify themselves and control how they connect with other users, promoting stronger emotional connections.
While these studies had a large amount of variation and had high risk of bias, this study was rigorous and the first to perform a meta-analysis on social media-based interventions in cancer. Oncology nurses have witnessed the social isolation and loneliness patients experience, especially during the pandemic when family caregivers have limited involvement.
For patients with quality of life and anxiety needs, social media interventions are an accessible way to promote a patient’s well-being. Knowing that interventions with specific features – including a variety of features and identity representation – can further assist oncology nurses in referring patients to the interventions from which they are most likely to benefit.