Behavior Change Around an Online Health Awareness Campaign: A Causal Impact Study

Abstract

National Eating Disorders Association conducts a NEDAwareness week every year, during which it publishes content on social media and news aimed to raise awareness of eating disorders. Measuring the impact of these actions is vital for maximizing the effectiveness of such interventions. This study is an effort to empirically measure the change in behavior of users who engage with NEDAwareness content, and compare the detected changes between campaigns in two different years. We analyze a total of 35,895 tweets generated during two campaigns of NEDAwareness campaigns in 2019 and 2020. In order to assess the reach of each campaign, we consider the users participating in the campaigns and their number of followers, as well as retweeting engagement. We use the Linguistic Inquiry and Word Count (LIWC) text modeling and causal impact analysis in order to gauge the change in self-expression of users who have interacted with the NEDAwareness content, compared to a baseline group of users. We further enrich our understanding of the users by extracting gender information from their display names. We find that, despite large media corporations (such as MTV and Teen Vogue) participating in the campaign, it is governmental and nonprofit accounts who are among the accounts that attract the most retweets. Whereas the most influential accounts were well-connected in 2019, the 2020 campaign saw little retweeting between such accounts, negatively impacting the reach of the material. Both campaigns engaged women at around 40% and men 17%, supporting previous research showing women to be more likely to share their experiences with eating disorders. Further, women were more likely to mention other health topics within the 15 days of the intervention, including pregnancy and abortion, as well as depression and anxiety, and to discuss the developing COVID pandemic in 2020. Despite the positive message of the campaign, we find that the users who have engaged with this content were more likely to mention the linguistic categories concerning anxiety and risk. Thus, we illustrate the complex, gender-specific effects of NEDAwareness online health intervention campaign on the continued self-expression of its audience and provide actionable insights for potential improvement of such public health efforts.

Keywords: Twitter; eating disorders; health informatics; health interventions; mental health; social media.