Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 31, 2023
Date Accepted: Jun 10, 2024
Linking opinions shared on social media about COVID-19 public health measures to adherence: repeated cross-sectional surveys of Twitter use in Canada
ABSTRACT
Background:
The effectiveness of public health measures (PHMs) depends on population adherence. Social media were suggested as a tool to assess adherence, but representativeness and accuracy issues have been raised.
Objective:
The objectives of this repeated cross-sectional study were to compare self-reported PHM adherence and sociodemographic characteristics among people who used Twitter or not.
Methods:
Repeated Canada-wide online surveys were conducted every 14 days, from September 2020 until March 2022. Using Bayesian logistic regression models, we investigated associations between Twitter use, as well as opinions in tweets, and self-reported adherence with mask-wearing and vaccination.
Results:
Data from 40,230 respondents were analyzed. As self-reported, Twitter was used by 21% of Canadians, of whom 30% tweeted about COVID-19. The sociodemographic characteristics differed across categories of Twitter use and opinions. Overall, 11% of Canadians reported poor adherence to PHMs. Twitter users who tweeted about COVID-19 reported poorer adherence to mask-wearing than non-users, which was modified by the age of the respondents and their geographical region (odds ratios: 0.79 (0.18-1.69) to 4.83 (3.13-6.86). The odds of poor adherence to vaccination of Twitter users who tweeted about COVID-19 were 1.76 (1.48-2.07) greater than of non-users. English- and French-speaking Twitter users who tweeted critically of PHMs were, respectively, 4.07 (3.38-4.80) and 7.31 (4.26-11.03) more likely to report poor adherence to mask-wearing than non-Twitter users, and those who tweeted in support were, respectively, 0.47 (0.31-0.64) and 0.96 (0.18-2.33) less likely. The odds of poor adherence to vaccination for those tweeting critically about PHMs and for those tweeting in support of PHMs were 4.10 (3.40-4.85) and 0.20 (0.10-0.32), respectively, compared to non-Twitter users.
Conclusions:
Opinions shared on Twitter can be useful to public health authorities as they are associated with adherence to PHMs. However, the sociodemographics of social media users do not represent the general population, calling for caution when using tweets to assess general population-level behaviours.
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