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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Mar 7, 2019
Open Peer Review Period: Mar 12, 2019 - May 7, 2019
Date Accepted: Apr 30, 2020
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis

Buente W, Dalisay F, Pokhrel P, Kramer HK, Pagano I

An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis

J Med Internet Res 2020;22(7):e13954

DOI: 10.2196/13954

PMID: 32673220

PMCID: 7381034

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis

  • Wayne Buente; 
  • Francis Dalisay; 
  • Pallav Pokhrel; 
  • Hanae Kurihara Kramer; 
  • Ian Pagano

Background:

A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platforms can be powerful tools for health communication. Studying the content of substance use on visual social media may provide valuable insights into public health interventions.

Objective:

This study aimed to explore and document the ways that betel nut is portrayed on the photo-sharing site Instagram. The analysis focuses on the hashtag #pugua, which refers to the local term for betel nut in Guam and other parts of Micronesia.

Methods:

An exploratory content analysis of 242 Instagram posts tagged #pugua was conducted based on previous research on substance use and Instagram and betel nut practices in Micronesia. In addition, the study examined the social engagement of betel nut content on the image-based platform.

Results:

The study findings revealed content themes referencing the betel nut or betel nut tree, betel nut preparation practices, and the unique social and cultural context surrounding betel nut activity in Guam and Micronesia. In addition, certain practices and cultural themes encouraged social engagement on Instagram.

Conclusions:

The findings from this study emphasize the cultural relevance of betel nut use in Micronesia. These findings provide a basis for empirically testing hypotheses related to the etiological roles of cultural identity and pride in shaping betel nut use behavior among Micronesians, particularly youths and young adults. Such research is likely to inform the development of culturally relevant betel nut prevention and cessation programs.


 Citation

Please cite as:

Buente W, Dalisay F, Pokhrel P, Kramer HK, Pagano I

An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis

J Med Internet Res 2020;22(7):e13954

DOI: 10.2196/13954

PMID: 32673220

PMCID: 7381034

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