Promoting Public Engagement with Palliative and End-of-life Care Discussions from Chinese Social Media: Model Development and Analysis

Yijun Wang, Han Zheng*, Yuxin Zhou, Jonathan Koffman, Emeka Chukwusa, Vasa Curcin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: In Chinese traditional culture, discussions surrounding death are often considered taboo, leading to a poor quality of death and limited public awareness and knowledge about Palliative and End-of-Life Care (PEoLC). However, the increasing prevalence of social media in health communication in China presents an opportunity to promote and educate the public about PEoLC through online discussions.

Objective: This study aimed to examine the factors influencing public engagement in PEoLC discussions on a Chinese social media platform and develop practice recommendations to promote such engagement.

Methods: We gathered 30,811 PEoLC-related posts on Weibo, the largest social media platform in China. Guided by the Elaboration Likelihood Model (ELM), our study examined factors across four dimensions: content theme, mood, information richness, and source credibility. Content theme was examined using thematic analysis, while sentiment analysis was employed to determine the mood of the posts. The impact of potential factors on post-engagement was quantified using negative binomial regression.

Results: Organizational accounts exhibited lower engagement compared to individual accounts (IRR<1, P<.001), suggesting an underutilization of organizational accounts in advocating for PEoLC on Weibo. Posts centred on PEoLC-related entertainment (films, TV shows, and books) (IRR=1.37, P<.001) or controversial social news (IRR=1.64, P<.001) garnered more engagement, primarily published by individual accounts. An interaction effect was observed between content theme and post mood, with posts featuring more negative sentiment generally attracting higher public engagement, except for educational-related posts (IRR=2.68, P<.001).

Conclusions: Overall, organizations faced challenges in capturing public attention and involving the public when promoting PEoLC on Chinese social media platforms. It is imperative to move beyond a traditional mode to incorporate cultural elements of social media, such as engaging influencers, leveraging entertainment content and social news, or utilizing visual elements, which can serve as effective catalysts in attracting public attention. These strategies, developed in this study, are particularly pertinent to non-profit organizations and academics aiming to utilize social media for PEoLC campaigns, fundraising efforts, or research dissemination.
Original languageEnglish
JournalJournal of Medical Internet Research
Publication statusAccepted/In press - 3 Jan 2025

Keywords

  • palliative care
  • end-of-life care
  • health promotion
  • social media
  • China
  • Weibo
  • public engagement
  • Elaboration Likelihood Model
  • ELM

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