JMIR Publications

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 30,812 PEoLC-related posts from 2009 to 2022 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, suggesting an underutilization of organizational accounts in advocating for PEoLC on Weibo. Posts centred on PEoLC-related entertainment (films, TV shows, and books) or social news 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.

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.