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Accepted for/Published in: JMIR Cancer

Date Submitted: Dec 10, 2024
Date Accepted: Jul 3, 2026

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

Understanding Social Media Strategies to Improve Engagement in and Equitable Dissemination of Online Cancer Nutrition Information: Cross-Sectional Study

Harrison E, Buzali-Soto S, Rillamas-Sun E, Greenlee H, Warner EL

Understanding Social Media Strategies to Improve Engagement in and Equitable Dissemination of Online Cancer Nutrition Information: Cross-Sectional Study

JMIR Cancer 2026;12:e69886

DOI: 10.2196/69886

PMID: 42600092

Understanding Social Media Strategies to Improve Engagement in and Equitable Dissemination of Online Cancer Nutrition Information: A Cross-sectional Study

  • Ellie Harrison; 
  • Sara Buzali-Soto; 
  • Eileen Rillamas-Sun; 
  • Heather Greenlee; 
  • Echo L Warner

ABSTRACT

Background:

Factors influencing engagement with cancer nutrition content on social media are poorly understood, despite the high prevalence of social media use for cancer information.

Objective:

We explored social media and linguistic characteristics associated with user engagement on a Facebook page used to disseminate evidence-based cancer nutrition information.

Methods:

This cross-sectional study analyzed N=306 cancer nutrition Facebook posts from the Fred Hutchinson Cancer Center’s bilingual (English/Spanish) Cook for Your Life (CFYL) website over 12 months (9 months before (T1) and 3 months after (T2) the bilingual content strategy implementation). User demographics and engagement metrics were extracted from Meta Business Suite. Manual coding assessed posts for branding, infographics, and visual content. Linguistic Inquiry Word Count (LIWC) analyzed valence and other linguistic dimensions. Statistical analyses compared variables, revealing social media and linguistic characteristics influencing engagement (e.g., number of likes, comments, shares).

Results:

Users who engaged with CFYL Facebook content were mostly female (93.2%), aged 55-64 years (26.6%), in the United States (71.4%), and English language users (93.4%). Engagement increased from T1 (mean number of engagements=5.3 (SD)=4.2) to T2 (mean=17.7 SD (37.9), p<0.01). There was a shift towards less complex sentence structures, increased analytical language, and a decline in emotionally charged and cognitive language in posts during T2. Posts that used bilingual content had 1.72 higher odds of audience engagement compared to English-only posts (CI: 1.05-2.80).

Conclusions:

Using bilingual and visual content may promote engagement with cancer nutrition messages on Facebook. We describe how a dedicated social media strategy increases engagement.


 Citation

Please cite as:

Harrison E, Buzali-Soto S, Rillamas-Sun E, Greenlee H, Warner EL

Understanding Social Media Strategies to Improve Engagement in and Equitable Dissemination of Online Cancer Nutrition Information: Cross-Sectional Study

JMIR Cancer 2026;12:e69886

DOI: 10.2196/69886

PMID: 42600092

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