Table 3 Main Findings, Challenges Encountered, and Conclusions of Eligible Studies

Al-Samaray et al. 2020 [44]

Social media posts have played a key role in shifting customers' minds about using herbal products. Herbal dental products are commonly used by people of all ages and educational levels. When used appropriately for the targeted audience through the appropriate social network, social media will guide the audience toward a specific product

Not reported

Herbal dental products are commonly used by people of all ages and educational levels. When used appropriately for the targeted audience through the appropriate social network, social media will guide the audience toward a specific product

Barnes et al. 2020 [45]

After 10 weeks of recruitment, 1418 participants had enrolled in the study, and of these 810 (57.1%) completed the 20-min (70 question) survey. Women participated from across Australia. Both paid and purposive approaches to promotion contributed to recruitment success. Paid promotions at higher costs for fewer days were the most successful. Total paid promotion costs were (Australian) $1147.97 (or $1.44 per completed survey). Purposive promotion was slower, but also contributed significantly to the number of people who saw the posts and clicked through to the survey. Traditional response rate calculations showed a response rate of 0.8%. Using post clicks and survey link clicks in calculations, resulted in response rates of 23.1% and 42.7%, respectively

To begin with, sampling biases are inherent because Facebook users do not fully represent the entire Australian population, and potential participants who were not Facebook users and/or did not have access to the Internet may have been missed. There was a lack of generalizability. Some of the study's limitations stem from Facebook's own privacy policies. Due to privacy restrictions that prevent Facebook from providing detailed demographic information about users who were exposed to promoted posts, it is not possible to report anything about non-responders when using Facebook. The research team was unable to be seen by the first author due to other Facebook privacy restrictions. The survey costs could not be fully reported, so they were not fully recorded. Finally, exact numbers of participants are impossible to determine. Researchers were unable to obtain any demographic or other information about potential participants who saw an advertisement but did not respond

Over a 10-week period, 1418 participants were successfully recruited using a combination of paid promotions, purposive and snowball recruitment on Facebook, resulting in 810 completed surveys at a low cost per participant. Additional methods for measuring response rates could be beneficial in determining the success of using Facebook posts for recruitment

Chan et al. 2020 [46]

Two themes were found for both registered dietitians (RD) and non-RD blogs: nutrition recommendations and service promotion/sponsorship, several themes were unique to RD or non-RD blogs

A larger sample of blogs could be more representative of the nutrition blogs that are available on the internet. During the data analysis, the researchers were not blinded, but multiple coders were used. The perceptions and retention of blog information were not assessed in this study. In addition, many of the blogs in this sample included images or pictures that could have added to the content but were not included in the analysis

The internet is a powerful tool for disseminating nutrition information to a large number of people. By providing evidence-based nutrition education, addressing current health trends, and making advice accessible to low-income people, RD bloggers can maximise their impact

Gierth et al. 2020 [47]

Prior judgements affect how the following are judged: user comments, the attacked claims, and the claim's source. After adjusting for attitude, people agree more with thematic complexity statements, but only when the comments are made by experts do the comments have a differing impact on perceived argument credibility. Furthermore, comments criticizing researchers' intentions were more effective in lowering perceived credibility, while comments criticizing scientists' expertise had no impact

There are some drawbacks to the research. For instance, the study was largely made up of students. In terms of science reception, students can vary in significant ways from the general population. Nonetheless, the young age of the sample and their willingness to pursue academic studies may have affected their attitudes toward research. We did not provide any conditions under which user comments were missing or irrelevant. We didn't test whether critical user comments affected reputation or trustworthiness, but rather whether discrepancies in content between different types of critical user comments were observed and influenced participants' reasoning. Another drawback is that people's impressions of science-related material on their own Facebook feeds may vary from the screenshots provided to experiment participants

In conclusion, despite the fact that the research was exploratory in nature, it is reasonable to conclude that the content of user comments can influence credibility assessments of science knowledge on social media, and that science communicators should be wary of the complexity argument's comparative effectiveness as an attack on science claims

Kawchuk et al. 2020 [48]

1. Twitter misinformation regarding a spinal manipulation therapy (SMT)/immunity link increased dramatically during the onset of the COVID-19 crisis

2. Activity levels (number of tweets) and engagement scores (likes + retweets) were roughly equal between content promoting or refuting a SMT/immunity link

3. potential reach (audience) of tweets refuting a SMT/immunity link was 3 times higher than those promoting a link

4. majority of tweets promoting a SMT/immunity link were generated in the USA while the majority of refuting tweets originated from Canada

Talkwalker's search results were not compared to those obtained through other services or methods. Twitter is a useful tool for investigating conversations within a social media community, but it is limited in that it does not represent all people on the planet. Some of the data in this study came from proprietary algorithms available from Talker-Walker Quick Search, but we didn't have access to the methods of calculation (e.g. sentiment scores)

During the COVID-19 crisis, there was an uptick in tweets about SMT and immunity. The findings of this study could aid policymakers and others in better understanding the impact of SMT misinformation and devising strategies to mitigate it

Merten et al. 2020 [49]

The majority of pins (91.6%) presented CBD in a positive light, with many citing physical or mental benefits such as relief from anxiety, depression, pain, and inflammation. The majority of pins (98.2%) failed to mention possible side effects or dosage recommendations. User participation was strong in this survey, with 85.2 percent of pins saved and links to commercial sites advertising CBD goods, personal blogs, and social media

This study has several limitations. Since there are so few Pinterest studies, there is a lack of agreement on sampling methodology when performing content analysis (Potter & Levine-Donnerstein, 1999). Pins were only collected for two months, with only every fifth pin being coded, and coding is subject to bias. Furthermore, the degree to which people act on things they pin is unclear on Pinterest, there is no demographic details, and there is no specific way to analyze time range. Despite the study's limitations, it provided insight into the effect of social media on health behaviour and reinforced the need for public health agencies to interact with the general public through social media to educate and counteract harmful health information

Social networking has evolved into a valuable source of health-related knowledge. With only a few credible public health outlets represented, this study revealed widespread approval of the use of CBD products

Allem et al. 2019 [50]

Prevalent topics of posts included using cannabis with mentions of cannabis initiation, processed cannabis products, and health and medical with posts suggesting that cannabis could help with cancer, sleep, pain, anxiety, depression, trauma, and posttraumatic stress disorder. Polysubstance use was a common topic with mentions of cocaine, heroin, ecstasy, lysergic acid diethylamide (LSD), meth, mushrooms, and Xanax along with cannabis. Social bots regularly made health claims about cannabis

Some one-grams and bigrams used to define topics may have multiple meanings that were overlooked in this study. Similarly, it is unclear whether the term "school" always denotes underage use, as college students or other professionals in the educational field may be adult cannabis users. It's possible that the findings do not apply to other social media platforms. The posts in this study were gathered over an eight-month period and may not be applicable to other time frames. The data was collected using Twitter's Streaming Application Programming Interface, which prevented posts from private accounts from being collected. The findings may not apply to all Twitter users or the entire population of the United States. This study was unable to determine the impact of different state cannabis policies on the public's experience with cannabis because not all tweets were covered by the established categories, and topics of conversation were not segmented by geographic location

The findings suggest that processed cannabis products, unsubstantiated health claims about cannabis products, and cannabis use in combination with legal and illegal substances should all be investigated further by public health researchers in the future

Aubrey et al. 2019 [51]

The effect of appearance-framed videos on state self-objectification scores was moderated by age, such that the effect of viewing the appearance-framed videos positively predicted state self-objectification among the younger adolescents. Three topics were chosen for the videos that could either be framed as appearance or health benefits: using sunscreen, drinking water, and doing yoga. In addition, self-objectification mediated the effect of condition on appearance anxiety and on their appearance-enhancing product preferences, again with the predicted effects supported for the younger adolescents in the sample

First, the experimental design of this study allows causal inferences to be drawn about the effects of framing on the outcome variables, however, it is not possible to determine the causal order of the further investigated linkages between self-objectification and appearance anxiety and appearance-enhancing product choice. In addition, in order to address the limitations of the Twenty Statements Test, the measurement of self objectification was done using a novel approach and only preliminary evidence of validity was presented. Furthermore, the study was conducted on a convenience sample of female adolescents, so it is very difficult to extrapolate the findings to other populations, such as females in the same age range who were not enrolled in Qualtrics Panels

Younger adolescent girls were the ones who were most affected by appearance-framed health advice. Furthermore, through self-objectification, the effects of condition on appearance anxiety and appearance-enhancing product choices were indirect. The framing of health advice has an impact on girls' responses to health advice messaging, and the response to the framing of health advice varies by adolescence

Younger adolescent girls appear to be the most vulnerable to appearance framing of health advice, as they are likely adapting to pubertal changes and are experiencing chronic monitoring of their appearance for the first time

Cano-Oron 2019 [52]

The sceptical movement occupies a dominant discursive position on Twitter

-The perspective is more balanced in digital dailies

- 79.1% of the tweets posted using the campaign hashtags were against complementary therapies (CT)s

- Tweets defending the use of CTs represented 3.3% of the sample and neutral ones 11.8%

- 54.7% of the tweets analyzed did not use or mention sources and the 15.3% that did, usually included links to other messages posted on social networks to websites in favour of CTs

- 46.2% of tweets did not refer to the ministry or minister of health accounts

- These accounts were mentioned to denounce publicly other accounts relating to these therapies

Sample came from only one campaign of the movement (the sceptical movement)

- Only tweets included in the search results of the hashtags were analyzed

- Lacked the ability to identify how many people had been exposed to its content

The goal of the study was to determine the sceptical movement’s discourse on complementary therapies in Spain. Hashtags relevant to the campaign, news articles published during the timeline of the study, and interviews with members relevant to the movement were assessed. The results determined that the movement has a strong, dominant position on Twitter in Spain, but is more balanced in digital dailies

Hasan et al. 2019 [53]

1. 65% of subjects had severe irritable bowel syndrome (IBS) pre-treatment, with the remaining 35% having moderate IBS

2. 65% of subjects exhibited a 50-point or more reduction in their total inflammatory bowel syndrome symptom severity (IBS-SSS) score following gut-focused hypnotherapy via Skype, which is regarded as being clinically significant

3. 30% of the subjects exhibited a 150-point or more improvement in their scores

4. Postintervention, 25% of subjects were classified as having severe IBS, 40% moderate IBS, and the remaining 35% mild IBS

A large randomised, controlled, noninferiority trial with more than 100 patients in each group would be required to fully answer this question. However, because Skype treatment is so effective in this desperate group of patients, it would be inappropriate to wait for the results of such a trial, which would be difficult to fund

When the availability of hypnotherapy locally is limited or when subjects find travelling difficult, Skype hypnotherapy appears to be a good alternative to face-to-face treatment

Hu et al. 2019 [54]

The most common adverse events (AE)s and adverse drug reactions (ADR)s in the monitoring system, primarily gastro-intestinal system disorders such as nausea, diarrhoea, and vomiting, were largely similar to those in literature and social media. From social media, 15 AEs were detected (0 unique ADR). When looking at the data, AEs, ADRs, and their affected system-organ classes appeared to be very similar, but they differed in every aspect when details were examined

Since we only collected data for one Chinese patent medicine (CSE), the generalizability of our findings is limited. In China, there is a low level of understanding of active reporting and tracking. CSE safety incidents could be underreported in the ADR tracking database. There were no post-market large-sample, multicenter, well-designed clinical trials for CSE protection. Traditional Chinese medicine items, in particular, need them. In randomized controlled trials (RCT)s, attempting to judge causal inference from AE to ADR was inadequate

The most common AEs and ADRs in our monitoring system, primarily gastro-intestinal system disorders such as nausea, diarrhoea, and vomiting, were largely similar to those in literature and social media. When looking at the specifics, however, data from various sources differed. To gather safety information regarding interventions, various data sources (the surveillance system, literature, and social media) should be incorporated. The distributions of adverse effects and adverse drug reactions from RCTs were the least close to data from other sources

Lacasse et al. 2019 [55]

Fitness (hashtag fitness) was the most cited word (n = 5491)

- Majority of words were categorized as "good feelings" (n = 32,747;51%) and appearance (n = 30,351; 42%)

- A small amount was categorized as traditional teachings (n = 1703; 3%)

- Images were mostly of women (n = 89; 89%), who were underweight (n = 68; 68%), in minimal clothing (70%), demonstrating a basic pose (n = 51; 51%), in an indoor environment (n = 57; 57%)

Small sample size compared to the large online content

#yoga on Instagram seems to have an emphasis on the physical nature of yoga which falls into line with the commercialization of yoga rather than the traditional teachings of yoga

Lognos et al. 2019 [56]

Patients with breast cancer predominantly use physical (37.6%) and nutritional (31.3%) therapies, according to the findings. Herbal medicine was a commonly mentioned subcategory

Medical characteristics (e.g., type and seriousness of cancer, number of recurrences, treatment time, comorbidities, health status, and risk behaviours) as well as personal (e.g., age), social (e.g., social status), and regional (e.g., France vs Francophonie) information on people who wrote a post are impossible to know. It is hard to say whether the same person shared the same thing several times on various social media sites. The networks' confidentiality laws make it difficult to tell with confidence that all published posts are from cancer patients

The exploratory study of breast cancer patient forums and Facebook discussion groups poses critical concerns about the reliability of complementary and alternative medicine (CAM) information accessible to patients and the role of regulatory authorities in labelling, approval, and surveillance

Majmundar et al. 2019 [57]

User experience (28.90%) and product appearance (21.80%) were predominant themes followed by promotions (10.08%), and flavours (1.01%). About 32.43% of posts referenced cannabis-related solutions, 2.98% of the posts mentioned nicotine-related solutions and 0.11% of the posts mentioned aromatherapy. Average Instagram users (24.89%) posted the majority of posts followed by vape vendors (20.72%), KandyPens’ official account (17.96%), vaping enthusiasts/advocates (10.75%) and influencers (0.45%)

This study's findings may not apply to other social media platforms or time periods. The nature of KandyPens on Twitter and Reddit should be investigated further in the future, as text-based data may provide additional insights. Our findings are specific to KandyPens and may not apply to other companies that sell similar goods. While KandyPens is thought to be popular among teenagers, the demographics of those discussing KandyPens on Instagram were not determined in this study. Additionally, Instagram users making their posts unavailable or deleting them is a characteristic of social media use and may introduce bias in the results if the deleted content is relevant to this research

KandyPens advertises its products as aromatherapy devices, but Instagram posts about the products rarely mentioned their ostensible purpose. To assess implications related to product appeal and abuse liability, future research should consider product design, user experience, and the co-use of nicotine and cannabis with KandyPens

Plachkinova et al. 2019 [58]

The most active contributors to the forums were CAM providers. Some patients also prefer face-to-face encounters with their doctors and complementary and alternative medicine practitioners because they are concerned about the privacy and protection of their health details being shared online. The proposed mobile app. It satisfies the users' requirements and provides them with a user-friendly interface that is intuitive and simple to navigate. People would like to use the service only if they could search for their problem directly, according to three of the six CAM providers. As a result, people should be able to quickly find answers to their questions or diagnoses. There were a total of 4097 users, which means that from March to November 2015, this many people visited the site. Finally, there were 15 organic searches, which indicates that 15 of the visitors arrived from a search engine. Despite the fact that this number is small in comparison to the total number of users, it is higher than anticipated because we did not perform any Search Engine Optimization (SEO). = 

The study had a small number of participants which may have influenced the data analysis, particularly given the lack of participation from Western physicians. In the interview sample, as well as among website users, there is an overrepresentation of CAM providers

CAM has been extensively researched, mostly to better understand its advantages and provide proof of effective healing methods. Mobile contact, on the other hand, has mostly been considered for use in health care. It's still unclear how CAM will benefit from Web 2.0 and the development of new communication networks to link patients, CAM practitioners, and traditional physicians. Patients' refusal to share CAM information with their doctors can result in harmful treatments with negative outcomes (Levin, 1996; Plaut, 1995). By involving CAM practitioners in the discussion, the proposed artefact will effectively bridge the divide and restore trust between patients and physicians

Rizvi et al. 2019 [59]

The most common topic group, “use and adverse effects,” accounted for 50 of the 200 topics. The Medical Dictionary for Regulatory Activities = System Organ Classification was used to classify the 15 categories under this subject. The accuracy of identifying questions that correctly correspond with the selected topics was found to be high (90–100% accurate). The findings could help us create a more detailed and organized dietary supplement (DS) resource focused on the information needs of consumers

There were some limitations to this study. We only analyzed questions in the alternative medicine sub-category of the “health” section, so we might have missed dietary supplement mentions in other sub-categories, such as mental health disorders and general health care. To obtain the corresponding questions, we only used preferred DS ingredient names and not their synonyms (e.g., scientific names, common names). Topic modelling has inherent limitations, for example, topics were created based on the statistical word distribution within the questions, resulting in topics with incoherent topic keywords

This study uses correlation explanation (CorEx)-based topic modelling to derive and understand the knowledge needs of consumers around dietary supplements. CorEx-based topic modelling was able to reliably classify specific topics embedded in a wide corpus of Yahoo! Answers data

Webb et al. 2018 [60]

Results revealed that #curvyfit images featured a greater representation of physical appearance–oriented aspects of fitness; #curvyyoga images more often conveyed larger body sizes, shapes, and body-as-process characteristics. Preliminary findings have important implications for counteracting weight-biased perceptions equating thinness with physical fitness and promoting yoga as an important health practice among individuals with a range of body sizes. Our initial stage findings also raise areas of future critical inquiry surrounding the complex messaging at the intersection of fat embodiment, curvy identification, and healthism that are particularly ripe for subsequent qualitative investigation with actual digital media users

Although the sample size was sufficient to detect the majority of effects, it may not have been large enough to capture the presence of lower base rate phenomena. It was difficult to provide more specific information about the distribution of each of those qualities. Directly surveying #curvyyoga and #curvyfit users would be beneficial. The psychological impact of and actual exercise behaviour following exposure to these images for higher-weight individuals who identify as "curvy" or "plus-size" would be beneficial for later stage analyses

The findings support the idea that not all curvy Fitspiration on social media is created equal. On the contrary, despite the fact that both Instagram hashtags included the word "curvy," they tended to reflect philosophically different views of health and fitness. Access to yoga as a practise and challenges to weight-biased stereotypes that dismiss the coexistence of being "fat and fit" increased

Yin et al. 2018 [61]

In total, the 100 videos were viewed more than 36.80 million times. Among them, 52 were consumer videos; 16 were professional videos; and 32 were news videos. Compared to news videos, the odds of consumer videos mentioning what cupping is were 85.90% lower

The findings might not apply to less popular videos or videos in other languages. If videos in other languages were included, the study would be strengthened, especially in areas where cupping therapy is very popular. The study's cross-sectional design failed to capture the changing dynamics of the videos' meta-data (eg, how the number of views changes with time). As cupping becomes more popular, practitioners should be aware of the possibility of misinformation

There are a plethora of consumer videos about cupping therapy on YouTube. The most popular videos on the subject, according to the current study, were derived from news sources. As information from that source becomes more popular among the general public, health professionals will need to increase their presence on YouTube in order to provide reliable information about this alternative therapy, which is becoming more popular

Dai and Hao 2017 [62]

Of all post traumatic stress disorder (PTSD)-related tweets, it was found that 5.3% of tweets were related to marijuana use. Marijuana related tweets reached a large audience. The marijuana related tweets were predominated by supporting opinions and the supporting tweets outnumbered the tweets that were against or neutral about marijuana use

One of the challenges in working with social media data is the amount of “noise” or “chatter” misinformation included in the data. In our study over 10% of marijuana-related tweets were from top 10 users, suggesting that some of these tweets might be sent through power users or twitter bots, not reflecting actual attitudes of the public

Study did not assess the trends over time and was unable to establish causal inferences. Used self-reported meta-data that might not have been accurate or not reflective of the users' current location. One of the challenges in working with social media data is the amount of “noise” or “chatter” misinformation included in the data

Twitter data suggest a proliferation of supporting marijuana use for PTSD treatments, especially in the states that legalized medical and/or recreational use of marijuana

Marcon et al. 2017 [63]

Our findings show that there are ongoing debates about the effectiveness and validity of chiropractic. Furthermore, although our research identifies a wide range of claims and debate characteristics, key findings reveal that those advocating “for chiropractic” depend heavily on personal anecdotes while also raising concerns about “pills” and the pharmaceutical industry. Opponents of chiropractic primarily argue that it is not adequately validated by proof or "research," and often provide links to additional literature to back up their arguments. In general, the debates have a low degree of animosity. This study indicates that YouTube is a place where people can explore and debate health-related issues like chiropractic because there are so many different viewpoints being discussed in so many ways. It also illuminates the logic that underpins various chiropractic-related viewpoints and claims

Not specified

This study adds to the body of knowledge about how social media platforms, such as YouTube, become forums for people to express their opinions, reflect on, and discuss health issues (Du, Rachul, Guo, & Caulfield, 2016; Marcon, Klostermann, & Caulfield, 2016; Radzikowski et al., 2016; Vance, Howe, & Dellavalle, 2009). This research focuses on the rhetoric used by both proponents and opponents of chiropractic

Bitcon et al. 2016 [64]

The search revealed a group of bloggers who voiced concerns about the direction Western Herbal Medicine (WHM) is taking and whether they are ethically responsive to global environmental pressures. They share the common value that WHM should remain a health care option that empowers and supports the community, and suggest this is best achieved by maintaining and sharing fundamental skills of plant identification, simple herbal product manufacturing and incorporating both science and tradition in their herbal practice

The study's chosen method may have limited its ability to reach out to other like-minded practitioners. This search did not capture the opinions of bloggers who wrote in languages other than English. Second, the initial sample's keywords were compiled from academic literature, so bloggers who used different terms to describe their blogs would have been overlooked. This bias would have carried over to the second stage of snowball samples, potentially leading to the omission of additional online communities and themes. Furthermore, because Google blog search was the only engine used for the initial collection of blogs, the study may have missed less widely linked blogs

According to Wahlberg (2010), the study demonstrates the existence of a group of herbalists who express their views through nine blogs "with genuine concerns about the direction that herbal medicine is taking." While other herbalists focus on developing professional clinical practise or developing herbal medicine research programmes, this group focuses on promoting herbal medicine as a tool for social justice and a way to strengthen the connection between plants and people

Guo et al. 2016 [65]

Concerned about both the effectiveness of learning and the associated learning load, the team created 20- to 30-min video clips. Fifty pregnant women from a nearby hospital and clinic were enrolled in the mindful yoga programme. A telephone follow-up with these users was conducted to validate their actual use. These participants' comments have also been compiled, which will help researchers better understand their preference and frequency of use. Some of the participants claimed that Facebook was easier to use because it allowed them to practise in the privacy of their own homes. Others said they favoured the digital versatile disc (DVD) because it had a larger screen than their handheld devices, which they used to access Facebook. The majority of the participants alternated between using both methods. One respondent claimed that she learned new yoga poses first by watching a DVD on TV

N/A

Despite the fact that this research is still ongoing, substantial insight in the creation and testing of social multimedia content has been gained. In terms of the Facebook website, it allows users to upload videos that are less than 1024 MB in size. For some users, accessing Facebook via smartphone, Laptop, or Smart TV is a viable choice. The study shows that social media can make health information accessible as the women in the study were able to easily access health educational materials delivered by health care providers through social media sites like Facebook

Krampe et al. 2013 [66]

The biggest surprise resulting from this dance-based therapy Skype session was the enthusiasm of the nursing students. This was the first time many of the students had engaged with older adults in a positive, energetic activity. This process has implications for community and long-term-care clinical settings and could be replicated with minimal resources. The feedback from the TigerPlace older adults varied and included the spectrum of supportive enthusiasm to moderate enjoyment. The challenge to see and hear the Saint Louis University School of Nursing (SLUSON) students posed the biggest problem, given the small screen on the computer used at TigerPlace. Both partners agree that an opportunity awaits SLUSON and TigerPlace to work on specific areas for improvement and enhancing the experience for the older adults: screen size, volume for the older adults, and room size. Another trial will be coordinated in 6 months

The sheer number of students (120) and the presence of five to six older adults was the first hurdle to overcome. The music presented some technical difficulties. The two most important areas at TigerPlace to improve are (1) music facilitation and (2) screen size. TigerPlace could benefit from a larger display. When the music was playing, it was difficult to hear the Lebed Method instructor and nurse at TigerPlace. It would be nice to have a better way to control the volume of the music, such as with a remote. The projector on the ceiling setup in the theatre didn't work

The students were able to see how technology can be used to build interactive relationships with older adults, which was a huge plus. This experience gave a better understanding of the interests and tolerances of the older adult population, as well as hands-on experience with cutting-edge technology in patient care. This technology could be used by nurse educators as well as nurses for activities and tasks that are not cost-effective or practical to complete in person. With the dedicated efforts of a few key individuals, Skype could become a viable option for connecting nurses and nursing students with patients in the future

Marcon et al. 2016 [67]

There were 34 tweets with clear scepticism or criticism of SMT, accounting for 2.68 percent of the overall sample (n = 1267). As a result, 2.68 percent of tweets in the total corpus (95 percent confidence interval 0–6.58 percent) express explicitly sceptical or critical views of SMT. There are also several tweets highlighting the health benefits of SMT for health problems like attention deficit hyperactivity disorder (ADHD), the immune system, and blood pressure, which receive little critical attention. There are a few tweets in the corpus that highlight the dangers of "stroke" and "vertebral artery dissection" (0.1 percent)

There are a few limitations to this study that should be considered. It can be difficult to compile a comprehensive set of tweets on any subject due to the nature of Twitter conversations and the very restricted access given by Twitter's application programming interfaces (API). Also, other possible words like "chiro" and "spinal change" are also present on Twitter, which may result in datasets with slightly different outcomes. Finally, considering the fact that December 2015 was selected at random, there is no reason to assume that other time periods will be slightly identical or dissimilar. Despite these limitations, this study shows how risk discussions and critical views on efficacy are almost non-existent on Twitter

There is a lack of skepticism surrounding the effectiveness of SMT on Twitter as the majority of tweets substantiated and encouraged chiropractic and SMT as sound health practices. While some critical voices of SMT are gaining traction, questions remain about how widely this knowledge is being disseminated

Robertson 2016 [68]

Treatment group A had substantial results between the mid/post-test and pre/post-test, but not treatment group B, indicating that a stimulation technique applied during the first two weeks encouraged them to visit the blog site even during the nonstimulus situation the last two weeks. Both groups gave the blog high scores for its utility in collecting knowledge about neonatal intensive care unit (NICU) music therapy services

Not specified

Overall, the blog seemed to increase primary care providers' understanding of NICU music therapy services. It was a successful way to disseminate relevant intervention knowledge as well as new research findings that are critical to the success of music therapy in the NICU. Participants were able to easily access valuable educational knowledge at their leisure, alleviating time constraints that are common in the medical community as a primary care provider

Keim-Malpass et al. 2013 [69]

The following thematic classifications were described: awakening, new identities (that incorporate loss), the good stuff, and release. The desire to achieve strength, peace, and the ability to heal both physically and emotionally were common attributes expressed before, during, and after CAM use. All of the women who utilized CAM described a similar series of events that culminated in a loss of control of what was happening to their bodies, usually acting as a point of initiation for complementary modalities. As treatment commenced, many of the young women were faced with new bodily identities that encompassed both physical changes and limitations in previous activities. The CAM use was often initiated by high symptom burden and an empowering desire to take a proactive and positive complementary approach to treatment. The described CAM use had both short-term impacts for combating negative disease experiences as well as longer-term impacts for enhanced cancer survivorship and positive lifestyle changes through stress reduction, mindfulness, physical activity, and more balanced nutritional choices

Beyond the experiences presented, the data is not generalizable. The identity of the person was not recorded. As a result, medical records could not confirm any disease or treatment-related details. Furthermore, because of the naturalistic approach, topics were only written about and discussed if they were important to the blog author

Online illness blogs allow researchers to gain a better understanding of the patient's entire experience through personal accounts, and they contribute significantly to the body of knowledge surrounding cancer in young adults and the use of complementary therapies

Krampe et al. 2016 [70]

1. The visual experience was better for the front and second rows. 2. All of the older adults (100%) reported hearing the audio adequately, regardless of position in the room. 100% of older adults with student partners enjoyed seeing the dancers along with the older adults in the second row. 3. The older adults with student partners and the second row reported 100% satisfaction and willingness to join this program again. 4. 100% of older adults reported hearing the audio adequately

There was some delay in audio with video, which may have been because Fuze was streaming both the video and the uploaded audio content at the same time. The visual component of Fuze was problematic at the school of nursing (SON). Participants at the SON stated that the video quality was not always sharp but somewhat blurry. This may be attributed to the fact that it was being streamed via Wi-Fi at the partner facility. There did not appear to be a wired Internet connection available near the TV at the facility. This issue might have been resolved with a wired connection. One important factor for improvement will be to avoid overwhelming the older adults. “It is difficult to watch the screen and dance leader at the same time” was a comment from 1 of older adults in the front row who had a student partner. The dance leader was stationed outside the camera view; a position in front of the large screen TV, off to one side, may improve this problem

Overall, Fuze is a feasible, engaging, and satisfying approach for dance-based therapy, with better audio and visual performance than Skype. The use of synchronous technology to provide therapeutic activities for older adults is an area of research and exploration that appears to have great potential. More trials are needed

Walden 2013 [71]

Individual and group credibility can be projected to stakeholders via blogs

There are a few shortcomings of this study. Interviewees may have been unable to go into great depth due to the short duration of the interviews. Though interviewees were wary of outside scrutiny, more in-depth probing about how naturopathic physicians perceive issues in their field may have been helpful. Also, these are my findings based on this small sample of 18 people, limiting generalizability

Blogs are recent examples of grey or alternative health literature that act as a “represent all of us” community feature. This study serves as a springboard for more qualitative and quantitative research in these fields, especially in the holistic medical community, to better understand how health information can be disseminated and medical practitioner identity can be discussed on Web 2.0 technologies

Gregory et al. 2012 [72]

Although very few educational institutions listed by the American Music Therapy Association provided documentaries on their websites, YouTube documentaries by a variety of posters were very prevalent. The largest proportion of YouTube documentary postings were originally created by professional news organizations and were, not surprisingly, effective in conveying objectives within videos of adequate length and audio/visual quality. Content included both video footage of clinical interactions showing clients and music therapists and didactic information through narrative overlays, interviews, and brief talks. However, professional credentials of music therapists were provided less frequently than credentials of non-music therapy interviewees and therapists, which highlighted missed opportunities for informing viewers of professional designations for music therapists. In addition, music therapy orientations were not identified in more than half of the documentaries, which prevented viewers from learning that diverse approaches exist within the music therapy profession. Even with these limitations, comparisons with results from a similar examination of YouTube music therapy session videos suggest that, generally speaking, online music therapy documentaries probably provide a more effective and accurate format for current educational and outreach purposes

Music therapists' professional credentials were provided less frequently than those of non-music therapy interviewees and therapists, highlighting missed opportunities to inform viewers about music therapists' professional designations. Furthermore, music therapy orientations were not identified in more than half of the documentaries, preventing viewers from learning about the variety of approaches available in the field of music therapy

Despite these challenges, comparisons to results from a similar study of YouTube music therapy session videos suggest that, in general, online music therapy documentaries are a more effective and accurate format for current educational and outreach purposes