How does information spread among communities?

Now, just to give an example, we will speak a little bit about the case of diabetes. How does technology play a role in diabetes? In this study of the central network analysis for characteristics in health social media, we look into the structure surrounding online communities of diabetes. What we wanted to know, it was whether the authentic user in those online communities, they have different health characteristics. Either if they have, different gender, different age, et cetera. When we analysed these seven communities, three of them they have those health-related data. And what we found was that those users in the centre, they tend to have more years living with their diagnosis. So those users, they are more acknowledgeable about their disease.

Helping the others at the end they are always in the centre, and the people not so centre, they tended to be the new patients, those with less experience living with the disease. This is very important because it shows that the trust within the online community of diabetes is related to their experience with the disease.

These other examples to analyse, is about how we can use online community to gather social health data. In the online community to diabetes, they have created a web application where you sort of can respond to surveys from public health researchers, and also track and share and compare their health data. Then later on you can see plotting them up. For example, in Tuanalyze, they use that application inside the online community to check whether the patients with diabetes, they knew about some announcement from the FDA. So these tools can help the FDA to get very quick data from the online communities.

Nowadays, we have so many diabetes apps that it’s becoming very challenging to find out which one we can use. Already in the year 2011, we did that review on mobile diabetes application, we found over 200 applications for diabetes, and the quality of some of them was quite low. And still, most of the diabetes they were focused on monitoring glucose management, but very few incorporated educational support, and even fewer have social media into it. Nowadays if you go to the health section in most of the– either in the Apple store, or in Google, you will find hundreds of applications, hundreds of thousands of applications.

Another tendency we are facing right now, is the developmental gadgets that can be integrated with the mobile phone. Either step counters to measure physical activity, and even glucometers that are attached to the phone. This is very important because it helps to increase adherence, either to the physical activity or to monitoring blood sugar levels. Here we have our example where we combine social media, big data, and gadgets. It’s the BiG blue test run by the Diabetes House Foundation. In this social games on how to say users are invited to measure their blood sugar values, exercise, and then to test again. This is a way to show the user how physical activity is regulating blood sugar values.

Then they combine all the data and they show the average to the users. So it’s a social learning experience. And at the end, they have managed to get a sponsor that will make a donation based on each test. So if there are 10,000 tests, there will be a bigger donation. As you can see, the participants in this social game, they are sharing how they did it in their social media accounts. And many of them are using actually smart watches and also mobile applications.

This is an example, the Diabetes Diary from the Norwegian Centre of Telemedicine and Integrated Care in Norway, where they are testing mobile applications for better management of diabetes type 2 as part of a very large European project called Renewing Health, where they are going to assess the impact of this type of application, the diabetes outcomes.

Now, the research in Norway, led by Eddie Olson, they are looking into how they can incorporate mobile games as a way to improve the self-monitoring and the self-management in kids with diabetes type 1. So when you play the game– actually, the input that you put in the game, that patients put in the game, can be later reviewed by the health care professionals. It’s a new way to monitor younger patients using games.

Also they are working in the development of applications for improving in the self-management using the smart watches. So that you don’t need to log into the application, spend a lot of time answering the new data, but you can just do it in your own watch. This is something quite new. They’re using the platform lever, and this is the first application for the evidence in that platform. It makes it easier to enter the data, and that will help to create more high quality data to improve their self-management. And also then following up from the health care professionals that can later on review the data. Now I will start the case of anorexia.

Anorexia is an eating disorder where people are eating very, very less, and it can be even life-threatening. It’s a mental disease, so it’s very common the patients, they don’t go see themselves to be sick, but they consider that eating so little is actually part of a lifestyle. And there are online community promoting anorexia pretty much in every type of social media. And this is something that has been reported since the late ’90s. If you go to Google you will find videos saying, anorexia is life style not a disease. Also you will find videos saying that in order to lose weight, you should just drink a lot of diet soda and even eat ice cubes, et cetera.

And those video are combined with photos of very thin models and also music. Back in 2013 we did a study with the Taipei Medical University. And we wanted to study the different characteristics of videos promoting anorexia, versus videos providing transferring health information of anorexia. And the results as you can see in this table, they were very shocking. Videos promoting anorexia, they have four times more favourites than the informative ones. And also as many response– twice as many as responses as the informative one. That’s very important because that means those videos are highly social, and therefore, they tend to be highly ranked.

Later on, in another study participating with Leif Jentoft, who is now working Microsoft Research, we wanted to study the interactions between the pro-anorexia community and the anti-anorexia community in Flickr. Flickr is a social network for sharing photos. And as you can see in this example, there are many photos of extremely thin models where the main goal of those photos is to encourage people to keep following a pro-anorexia lifestyle. You can see in that photo that they’re tags ribs eating disorder are very common. Although they don’t consider themselves to be sick, they are using medical terms. Many try to get people who are searching for transferring information about eating disorder.

This figure, you can see how this social networks are structured in Flickr. In the top left you have a social network. The red dots are the pro-anorexia members, and the blue dots, the anti-anorexia members. As you can see that they are very clustered. So you have reds are together with the red, the blue with the blue. And that network was the world the ages between the nodes are according to their contacts. So you can see that people pro-anorexia, they tend to be friends with those that are pro-anorexia, and otherwise. In the other hand, in the bottom left, you see that it’s very blurry. That it’s very hard to distinguish where are the reds, and where are the blue.

That network was built using as an age the contacts within the user. And this is very blurry because people promoting anorexia they are using also mental terms just to try to get people from the other account. So it’s pretty much like a fight between two communities trying to get people from one into the other and otherwise. And in the case of pro-anorexia, you will also find nowadays applications promoting anorexia like this one from Android. It’s called Thinspo. Also it’s very common that people with eating disorder, they are using fitness applications and weight-loss applications to reach completely healthy goals.