JMIR Publications

ABSTRACT

Background:

Over the past decade, the rise of social media has profoundly transformed the ways health information is disseminated and discussed. Social media platforms such as Twitter/X have become key spaces where users can share their experiences and opinions regarding traditional, complementary, and alternative medicines (TCAM). However, trends on social media, particularly during the COVID-19 pandemic, remain poorly documented.

Objective:

The study aimed to characterize temporal trends in TCAM-related discourse on X (formerly Twitter) across English, Spanish, and French between 2015 and 2024.

Methods:

We conducted a retrospective observational analysis of annual mention counts in public X posts in English, Spanish, and French that contained 39 main TCAM-related terms over the 2015-2024 period. Descriptive analyses summarized cumulative mentions. Inferential trend analyses were restricted to the 2015-2019 period and used term-wise ordinary least squares regression. Trends were retained if R² ≥ 0.70 and an exact permutation test on the slope yielded P≤.05 (120 permutations, exhaustive given 5 observations). Uncertainty around 2015-2019 relative changes was quantified using 95% bootstrap percentile confidence intervals.

Results:

Cumulative mentions of the 39 TCAM-related terms totalled 191,994,848 over 2015-2024. The most frequently cited terms were “yoga” (79,618,183), “meditation” (55,560,372), and “mindfulness” (18,915,377), together accounting for 80.3% of all mentions. Cumulative mentions were predominantly in English (88.6%) compared to French (8.9%) and Spanish (2.5%). For example, “yoga” was used 71,203,218 times in English, 7,370,196 in Spanish, and 1,044,769 in French. Annual trajectories showed no order-of-magnitude surges among the top 10 terms; the largest year-to-year increase from 2019 to 2020 was observed for “ayurveda” (+186%). Trend analyses over 2015-2019 identified 14 significant terms in English (13 decreasing; 1 increasing +229% “intermittent fasting”), 8 in Spanish (3 increasing), and 11 in French (5 increasing). The terms “reiki” and “reflexology” decreased in all three languages.

Conclusions:

Between 2015 and 2024, the text-based analyses related to TCAM on X (formerly Twitter) were highly concentrated in a small set of body-mind practice labels and in English compared to Spanish and French. No peak was observed across the overall TCAM corpus during the COVID-19 pandemic, although isolated terms such as “ayurveda” showed marked short-term increases. The results indicate a relative stability of TCAM-related needs and concerns. These findings reflect mention frequency only and cannot be interpreted as indicators of professional practice or actual consumer use.