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Sharing Information Promoting Unhealthy Behavior Through Social Media Examination of the Users and the Content Using the Case of Pro-Anorexia in Tumblr

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2015 International Conference on Computational Science and Computational Intelligence Sharing Information Promoting Unhealthy Behavior through Social Media Examination of the Users and the Content Using the Case of Pro-anorexia in Tumblr Margaret McLaughlin Mina Park Yao Sun Annenberg School for Annenberg School for Annenberg School for Communication and Journalism Communication and Journalism Communication and Journalism University of Southern California University of Southern California University of Southern California Los Angeles, CA, USA Los Angeles, CA, USA Los Angeles, CA, USA [email protected] [email protected] [email protected] Abstract— Social media provides a place where individuals on avoiding detection by professionals and family members obtain health information and share social support. Previous when skipping meals. Researchers concluded that overweight literature, however, has suggested that social media may promote and people of normal weight were seen as being weak in the harm when users share information advocating unhealthy pro-anorexia community, and community members believed behaviors. By focusing on online discourse around pro-anorexia strength and beauty were attained through thinness [7-9]. content on Tumblr (the promotion of behaviors related to the eating disorder based on a lifestyle view that being extremely thin This “dark side” of social media in healthcare should be is beautiful), this study aims to look at how information about the urgently examined because information promoting unhealthy pro-anorexia perspective is circulated among social media users behavior is prevalent in social media. For example, user- and the way in which such users can be characterized. generated videos on YouTube portraying smoking positively Specifically, we plan to analyze the content and examine the far outnumbered those portraying smoking negatively [6, 12, shared characteristics of the users who are exposed to similar 13], and received a greater number of views [12]. It was also social media content and have a desire to share it. found that smokeless tobacco content on social media was popular among youth and most of the messages positively Keywords—information propagation; social media; unhealthy described smokeless tobacco [14]. The information frequently behavior; pro-anorexia; Tumblr portrays unhealthy behavior as attractive. For example, many individuals shared videos on YouTube featuring sexy, young, I. INTRODUCTION and healthy-looking females smoking [15]. Riskier or more Communication technology today provides a place where extreme unhealthy behaviors such as self-harm or suicide are individuals obtain health information and share social support also commonly observed. For example, there are numerous [1]. Many people may feel uncomfortable discussing their reports of non-suicidal self-injury videos and suicide health issues with their friends, feeling stigmatized or judged. announcement on social media [16-19]. Among suicide-related Further, they may think their family or friends lack experience websites that were available on the Internet and via social and have limited information about their issues [2]. Research media, approximately half were pro-suicide sites. In pro- has found social media as influential communication tools in suicide communities, people shared information on effective healthcare because it allows people to find like-minded others methods or stories about persons who committed suicide [20- to communicate with, and makes them feel more comfortable 22]. Some individuals even made ‘suicide pacts’ to commit about asking questions or sharing their experiences [3]. Thus, suicide together. individuals can more actively participate in a conversation around health issues in social media. We conducted a study of sharing information promoting unhealthy behavior through social media. This study reported In reality, while social media have been promoted as here focuses on online discourse around pro-anorexia in beneficial communication channels in healthcare [4, 5], recent Tumblr. Pro-anorexia, more popularly known as ‘proana’ in research has found that social media are frequently used to social media, is a view that being extremely thin is beautiful, share information promoting unhealthy behavior and that such and advocates as a lifestyle choice what the medical information easily reaches people who are engaging in the establishment and popular belief consider to be an eating risky health behavior. For example, it is found that like-minded disorder. Proana voices have been widely disseminated through people formed pro-smoking online communities or created social media. Much concern has been expressed about proana virtual smoking clubs. In the communities or the clubs, people because many young people, even as young as 12 years old, share pro-smoking messages from pictures of celebrity have accessed the content. Social media, especially Tumblr, smokers to information on smoker’s rights [6]. Research also were blamed for being responsible for promoting harmful found that people in pro-anorexia communities commonly behavior. Tumblr’s features allowed people to anonymously shared information about effective weight loss including the share both pictures of extremely thin people and motivational use of weight loss drugs [7–11]. They shared photos of thin comments. That is, proana advocates did not have to be celebrities as motivation, grossly obese people as warnings, concerned about being stigmatized by close others in the and themselves for others to comment on and encourage. They Tumblr space and this space become the most popular also supported each other in their weight-loss targets and tips sanctuary for their community. As a result, Tumblr 978-1-4673-9795-7/15 $31.00 © 2015 IEEE 801800 DOI 10.1109/CSCI.2015.122 administrators decided to shut down their proana communities individuals from major crises and everyday sources of stress in 2012. They removed eating disorder-related content and that they may experience [30]. Therefore, supportive messages regulated related search terms, such as “thinspiration.” People that provide emotional acceptance, allow cathartic ventilation, still are able to find the content, but they now see warning and encourage perspective shifting might fulfill needs that are messages with hotlines to call when they type anorexia-related not being met in individuals’ offline lives, and create a place terms. Despite the efforts toward regulation of such content, of safety compared to offline social networks that could make blog posts promoting anorexia continue to thrive. them feel stigmatized [2, 9, 31] Our study aims to explore how information about anorexia C. Aims and Objectives is being circulated among Tumblr users and who are sharing the similar content. We plan to analyze the content and This study aims to explore how information about anorexia examine the characteristics of the users who share the similar is being circulated among Tumblr users. We chose to look at posts on pro-anorexia. Tumblr as the most popular microblogging site for proana communities. Based on the discussion above, we are particularly interested in seeing the characteristics of highly propagated content. Specifically, we will examine whether II. RELATED WORK attitude toward anorexia (pro vs. anti) and affective tone A. The Use of Social Media for Unhealthy Individuals (positive vs. negative) influence information propagation. We are also interested in the shared characteristics between users Risky health behaviors, such as anorexia, are often socially who post similar content about anorexia. To examine this, we unacceptable and individuals who engage in those behaviors will investigate the association between users’ characteristics, often are stigmatized as socially deviant [7, 9]. As a result, they including popularities, network positions, and social media are motivated to hide their risky health behaviors from others, activities, in sharing information promoting unhealthy especially from those whom they are emotionally attached, to behavior. avoid the hurt they may face. Thus, individuals engaging in risky health behaviors have a small chance of finding similar others in offline interactions III. METHODS with their family and circle of friends. Typically, individuals who share “acceptable” health concerns easily get information A. Social Media Data offline about how similar others cope with their health issues. Publicly available blog posts in Tumblr that contained the They can learn what health-related perspectives others have, keyword “thinspo,” “wannarexic,” “proana,” “starvation and understand their personal stories by using a common buddy,” “eating disorder,” and “anorexia” were collected language that need not be explained or justified [23]. through DiscoverText, a cloud-based text analytics program. A Compared with people engaging in risky health behaviors, total of 36,248 blog posts posted between May 7 and June 6, people engaging in socially accepted health behaviors could 2014 were obtained. Among these blog posts, 35,432 (97.9%) easily access information about their health issues and have were in English, and the other 816 (2.1%) were in other low barriers to talking about their health behaviors with their languages. For the analysis, only English blog posts will be close network. On the other hand, since people engaging in included. risky health behavior have difficulty in finding similar others offline, they might have a lack of knowledge about the Tumblr allows users to choose
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